Sustainable development and child health in the Curitiba metropolitan mesoregion, State of Paraná, Brazil.

The purpose of this study was to analyze social determinants of health through the relationship between Sustainable Development and child health outcomes. The population studied lives in 37 municipalities of the Curitiba mesoregion, in the State of Paraná, Brazil. It is a cross-cutting ecological study. In the 1st phase of the study, 16 contextual indicators were obtained from the 2010 demographic census performed by the Brazilian Institute of Geography and Statistics. Principal Components Factor Analysis was undertaken to demonstrate possible correlations between social determinants of health, resulting in Sustainable Development indices for the places where the children live. In the 2nd phase the mortality rate in children aged under 5 was obtained from the Ministry of Health database. Pearson's correlation demonstrated statistically significant, moderate and negative association between the mortality rate in children aged under 5 (2001-2010) and the Sustainable Development Index (r = -0.62, p<0.01); with the Equity component (r = -0.70, p<0.01); and with the clusters (r = -0.68, p<0.01). Contextual indicators of Sustainable Development for the places where the children live showed themselves to be associated with the child health outcome. As such, equitable and sustainable social policies, based on inclusive health promotion strategies, need to be integrated into the children's life context.

[Analysis of water fluoride concentration in Curitiba, Brazil: comparison of techniques]. / Análise da concentração de flúor na água em Curitiba, Brasil: comparação entre técnicas.

OBJECTIVE: To evaluate the adequacy of fluoride levels in the public water system in Curitiba, state of Paraná, Brazil, as determined by two techniques (colorimetric and electrometric). METHODS: Data from independent measurements of fluoride in the public water system in Curitiba routinely performed by the city government were obtained for the period between January 2000 and July 2008. Mean levels of fluoride concentration were calculated for each of these years. After that, fluoride concentrations measured in 1 470 samples by the state water utility (SANEPAR) using the electrometric technique in 2006 and 2007 were compared with the corresponding levels measured by the city using the colorimetric method. The rate of samples meeting the standard for the city (0.8 ppmF), and below and above the standard, was calculated for both methods. Fluoride levels were compared between sanitary districts, months for the period between December 2007 and July 2008, and water treatment facilities. RESULTS: The overall mean fluoride level between 2000 and 2008 was 0.7 ppmF based on the independent measurements. The comparison between techniques showed a higher mean fluoride level with the electrometric technique (0.743 ppmF ± 0.133) vs. the colorimetric technique (0.637 ppmF ± 0.164). The rate of samples meeting the ideal standard of 0.8 ppmF was 15.05% for the colorimetric and 63.97% for the electrometric technique; 62.03% and 22.85% of the samples were below that standard and 21.10% and 13.18% were above that standard, respectively. Fluoride levels were statistically significant (P < 0.001) for the comparison between sanitary districts and months. CONCLUSIONS: The choice of technique significantly influences the resulting levels of fluoride. Independent monitoring of fluoride levels should employ the same technique used by the water utility. Further studies should aim at defining which technique is the most adequate to determine fluoride concentration in public water systems.