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1.
Rev Bras Epidemiol ; 23: e200003, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32130392

RESUMO

INTRODUCTION: The intake of sugar-sweetened beverages (SSB) varies according to the characteristics of the population. OBJECTIVE: To investigate the SSB intake and demographic, socioeconomic and lifestyle factors associated with its consumption in adolescents, adults, and older adults in São Paulo. METHODS: Data were drawn from the Health Survey of São Paulo, a cross-sectional population-based study including 1,662 individuals aged 12 years or more. SSB were classified into six groups: sugar-sweetened sodas, sweetened coffee and tea, sweetened milk and dairy products, sweetened fruit juice, sweetened fruit drink, and total SSB. The association of each group with demographic, socioeconomic and lifestyle variables was assessed using linear regression models. RESULTS: The mean SSB intake was 668.4 mL in adolescents, 502.6 mL in adults, and 358.2 mL in elderly adults. Sodas and sweetened coffee and tea represented had the greatest contribution to energy intake. SSB consumption was lower among female sex and higher among overweight adolescents, among sufficiently active adults, and among lower household per capita income older adults. Consumption of SSB was high, particularly among adolescents. Public policies are required in order to decrease the consumption of these beverages. CONCLUSION: Age group, sex, household per capita income, and body mass index status were associated with SSB intake.


Assuntos
Comportamento de Ingestão de Líquido , Estilo de Vida , /estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos Transversais , Ingestão de Energia , Humanos , Pessoa de Meia-Idade , Inquéritos Nutricionais , Sobrepeso/epidemiologia , Distribuição por Sexo , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
2.
Rev Bras Epidemiol ; 22: e190057, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31826113

RESUMO

OBJECTIVE: To describe the prevalence of health services utilization for control of arterial hypertension (AH) and diabetes mellitus (DM) in the city of São Paulo in 2003, 2008 and 2015 and to analyze associated factors to this utilization in 2015. METHODS: Data regarding adults who participated in the Health Surveys conducted in the city of Sao Paulo, ISA-Capital 2003, 2008 and 2015, were analyzed. Prevalences and 95% confidence intervals for the three years were estimated to describe the prevalence of the use of services to control HA and DM. For the year of 2015, prevalences of the same variables were estimated according to sociodemographic, geographic and health characteristics. Multinomial logistic regression was used to estimate AH and DM analysis models. RESULTS: There was a significant increase in the prevalence of people who reported routine health services utilization to control AH and DM in the period 2003-2015. For 2015, an increased routine health services utilization to control AH was observed among elderly and those who reported health insurance. For those who reported DM, an association between health services utilization and low schooling was found. Being elderly reduces the risk of not going to the health services to control AH, while being male and not having a health insurance increase this risk significantly. CONCLUSIONS: to identify how individuals with AH and DM use health services in way to control these diseases is very important to reduce access barriers and, yet, provide guidance in health policies to reduce disparities.


Assuntos
Diabetes Mellitus/prevenção & controle , Acesso aos Serviços de Saúde/estatística & dados numéricos , Hipertensão/prevenção & controle , Adulto , Fatores Etários , Brasil , Diabetes Mellitus/epidemiologia , Utilização de Instalações e Serviços , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , População Urbana , Adulto Jovem
3.
Public Health Nutr ; : 1-12, 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31847928

RESUMO

OBJECTIVE: To investigate the association among social determinants, lifestyle variables and diet quality in São Paulo, Brazil. DESIGN: Cross-sectional study, 2015 Health Survey of São Paulo (Inquérito de Saúde de São Paulo (2015 ISA-Capital)) with Focus on Nutrition Study (2015 ISA-Nutrition). SETTING: Population-based study, with a representative sample of adults living in São Paulo, Brazil. PARTICIPANTS: Adults (aged 20-59 years, n 643) and older adults (aged ≥60 years, n 545). RESULTS: We observed differences in the Brazilian Healthy Eating Index-Revised (BHEI-R) by education, income, occupation, sex and race. Whole grains (0·63 points, 12·6 % of the maximum score), sodium (2·50 points, 25·0 %) and solid fat, alcohol and added sugars (9·28 points, 46·4 %) components had the lowest BHEI-R scores. Factors positively associated with diet quality included the presence of one disease or more (e.g. diabetes mellitus, hypertension, cancer, hypercholesterolaemia: ß = 0·636, P < 0·001), income (middle income: ß = 0·478, P < 0·001; high income: ß = 0·966, P < 0·001) and occupation (other: ß = 1·418, P < 0·001). Energy (ß = -0·001, P < 0·001), alcohol consumption (ß = -0·207, P = 0·027), education level (middle education: ß = -0·975, P < 0·001; high education: ß = -1·376, P < 0·001), races other than white (ß = -0·366, P < 0·001) and being unemployed (ß = -0·369, P < 0·046) were negatively associated with diet quality. CONCLUSIONS: Groups affected by socio-economic inequalities need better diet quality. Governmental actions should be implemented to reduce the consumption of energy-dense and sodium-rich foods, facilitate access and information on healthy eating, and conduct nutritional education.

4.
Cad Saude Publica ; 35(11): e00236318, 2019.
Artigo em Português | MEDLINE | ID: mdl-31691788

RESUMO

Studies in developing countries report a steady increase in mental disorders, with major social and economic repercussions. The current study proposes to analyze the prevalence of common mental disorders (CMDs) and associated factors in urban residents of São Paulo, Brazil. Based on data collected in the Health Survey in São Paulo City (ISA-Capital) in 2015, the study identified the presence of CMDs using the Self-Reporting Questionnaire (SRQ-20). The association of CMDs with sociodemographic variables and health conditions was analyzed as relative frequency, corrected by the respective weights resulting from cluster sampling, estimating the prevalence and 95% confidence intervals (95%CI) and assessing the association's significance by the chi-square test, corrected by the F distribution. Prevalence of CMDs was 19.7% (95%CI: 18.2-21.4), higher in women (24.3%); persons 60 years or older (25.3%); followers of the African-Brazilian umbanda or candomblé religions (37.8%); widows/widowers (30.4%); individuals that had never attended school (31.4%); unemployed (28.3%); those with family income up to one minimum wage (28.8%); individuals that reported illness in the previous 15 days (36.9%); those with physical disabilities (21.6%); mental or intellectual disabilities (44.4%); emotional or mental problems (48.9%); headache (33.63%); and individuals with one or more chronic diseases (24.1%). The information in this study reaffirms the relevance of the prevalence of CMDs and their association with the most vulnerable social groups, corroborating the need to implement public measures in mental health.

5.
Rev Bras Epidemiol ; 22: e190050, 2019 Aug 22.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31460665

RESUMO

INTRODUCTION: The excessive sitting time involved in activities of low energy expenditure (sedentary behavior) can contribute to the development of chronic diseases. Assessing factors related to this behavior in a population is important to identify its most vulnerable segments. OBJECTIVE: To describe sitting time distribution in the adult population of São Paulo City according to sociodemographic and environmental characteristics and health conditions. METHODS: This is a cross-sectional study involving 2,512 individuals, aged 20 to 65 years, who participated in the Health Survey in the City of São Paulo (Inquérito de Saúde no Município de São Paulo - ISA-Capital) 2015. Data relating to sitting time were collected using the International Physical Activity Questionnaire (IPAQ), initially analyzed continuously, and, afterward, dichotomized by the median to analyze categorical variables. RESULTS: The total sitting time median in the sample was 180 min/day. The variables that, after adjustments, remained related to sedentary behavior were: schooling (prevalence ratio - PR = 1.41; 95% confidence interval - 95%CI 1.35 - 1.48); marital status (PR = 1.05; 95%CI 1.02 - 1.08); neighborhood safety (PR = 0.96; 95%CI 0.93 - 0.99); age (PR = 0.91; 95%CI 0.87 - 0.95); income (PR = 1.07; 95%CI 1.00 - 1.15); self-rated health (PR = 1.03; 95%CI 1.01 - 1.07), and gender (PR = 0.96; 95%CI 0.94 - 0.99). CONCLUSION: The most vulnerable groups to sedentary behavior in this population are: younger males, with higher schooling and income, who live in neighborhoods considered safe, unmarried, and with negative self-rated health.


Assuntos
Comportamento Sedentário , Postura Sentada , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Valores de Referência , Autorrelato , Distribuição por Sexo , Fatores Sexuais , Fatores Socioeconômicos , Fatores de Tempo
6.
Cad. Saúde Pública (Online) ; 35(11): e00236318, 2019. tab
Artigo em Português | LILACS-Express | ID: biblio-1039401

RESUMO

Resumo: Estudos realizados nos países em desenvolvimento descrevem um aumento progressivo dos transtornos mentais, com grandes repercussões sociais e econômicas. O presente estudo se propõe a analisar a prevalência dos transtornos mentais comuns (TMC) e seus fatores associados nos moradores da área urbana da cidade de São Paulo, Brasil. A partir dos dados levantados pelo Inquérito de Saúde do Município de São Paulo (ISA-Capital) de 2015, foi identificada a presença de TMC com a utilização do Self-Reporting Questionnaire (SRQ-20). A associação de TMC com as variáveis sociodemográficas e de condições de saúde foi analisada pela frequência relativa, corrigida pelos respectivos pesos decorrentes de uma amostragem de conglomerados, estimando-se a prevalência e intervalos de 95% de confiança (IC95%) em cada situação e avaliando-se a significância da associação pelo qui-quadrado corrigido pela distribuição F. A prevalência de TMC encontrada foi de 19,7% (IC95%: 18,2-21,4), sendo maior nas seguintes categorias: mulheres (24,3%); pessoas com 60 anos ou mais (25,3%); praticantes da umbanda/candomblé (37,8%); viúvos (30,4%); quem nunca frequentou a escola (31,4%); inativos/desempregados (28,3%); e quem possuía renda familiar de até um salário mínimo (28,8%). Em relação às variáveis de condição de saúde, a prevalência de TMC foi maior nos indivíduos que referiram: morbidade nos últimos 15 dias (36,9%); deficiência física (21,6%); deficiência mental ou intelectual (44,4%); problema emocional ou mental (48,9%); cefaleia (33,63%); e nos portadores de uma ou mais doenças crônicas (24,1%). As informações desta pesquisa reafirmam a relevância da prevalência de TMC assim como sua associação com os grupos sociais mais vulneráveis, o que reforça a necessidade da implementação de medidas públicas de saúde mental.


Abstract: Studies in developing countries report a steady increase in mental disorders, with major social and economic repercussions. The current study proposes to analyze the prevalence of common mental disorders (CMDs) and associated factors in urban residents of São Paulo, Brazil. Based on data collected in the Health Survey in São Paulo City (ISA-Capital) in 2015, the study identified the presence of CMDs using the Self-Reporting Questionnaire (SRQ-20). The association of CMDs with sociodemographic variables and health conditions was analyzed as relative frequency, corrected by the respective weights resulting from cluster sampling, estimating the prevalence and 95% confidence intervals (95%CI) and assessing the association's significance by the chi-square test, corrected by the F distribution. Prevalence of CMDs was 19.7% (95%CI: 18.2-21.4), higher in women (24.3%); persons 60 years or older (25.3%); followers of the African-Brazilian umbanda or candomblé religions (37.8%); widows/widowers (30.4%); individuals that had never attended school (31.4%); unemployed (28.3%); those with family income up to one minimum wage (28.8%); individuals that reported illness in the previous 15 days (36.9%); those with physical disabilities (21.6%); mental or intellectual disabilities (44.4%); emotional or mental problems (48.9%); headache (33.63%); and individuals with one or more chronic diseases (24.1%). The information in this study reaffirms the relevance of the prevalence of CMDs and their association with the most vulnerable social groups, corroborating the need to implement public measures in mental health.


Resumen: Estudios realizados en los países en desarrollo describen un aumento progresivo de los trastornos mentales, con grandes repercusiones sociales y económicas. El presente estudio se propone analizar la prevalencia de los trastornos mentales comunes (TMC) y sus factores asociados en los habitantes del área urbana de la ciudad de São Paulo, Brasil. A partir de los datos recabados por la Encuesta de Salud en el Municipio de São Paulo (ISA-Capital) de 2015, se identificó la presencia de TMC con la utilización del Self-Reporting Questionnaire (SRQ-20). La asociación de TMC con las variables sociodemográficas y de condiciones de salud se analizó a través de la frecuencia relativa, corregida por los respectivos pesos derivados de una muestra de conglomerados, estimándose la prevalencia y intervalos de confianza (IC95%) y evaluándose la significancia de la asociación por el chi-cuadrado, corregido por la distribución F. La prevalencia de TMC encontrada fue de 19,7% (IC95%: 18,2-21,4), siendo mayor en mujeres (24,3%); personas con 60 años o más (25,3%); practicantes de umbanda/candomblé (37,8%); viudos (30,4%); que nunca asistieron a la escuela (31,4%); inactivos/desempleados (28,3%); quienes tenía una renta familiar de hasta un salario mínimo (28,8%); individuos que informaron morbilidad durante los últimos 15 días (36,9%); deficiencia física (21,6%); deficiencia mental o intelectual (44,4%); problema emocional o mental (48,9%); cefalea (33,63%); y en los portadores de una o más enfermedades crónicas (24,1%). La información de esta investigación reafirma la relevancia de la prevalencia de TMC, así como su asociación con los grupos sociales más vulnerables, lo que refuerza la necesidad de la implementación de medidas públicas de salud mental.

7.
Rev. bras. epidemiol ; 22: e190050, 2019. tab
Artigo em Português | LILACS-Express | ID: biblio-1020560

RESUMO

RESUMO: Introdução: O excessivo tempo sentado envolvido em atividades de baixo gasto energético (comportamento sedentário) pode contribuir para o desenvolvimento de doenças crônicas. Avaliar fatores associados a esse comportamento numa população é importante para identificação dos segmentos mais vulneráveis. Objetivo: Descrever a distribuição do tempo sentado na população adulta do município de São Paulo segundo características sociodemográficas, ambientais e de condições de saúde. Metodologia: Estudo transversal envolvendo 2.512 participantes do Inquérito de Saúde no município de São Paulo (ISA-Capital) 2015, com idade entre 20 e 65 anos. Os dados referentes ao tempo sentado foram coletados por meio do Questionário Internacional de Atividade Física (IPAQ), analisados inicialmente na forma contínua e, a seguir, dicotomizados pela mediana, para a análise de dados categóricos. Resultados: A mediana de tempo sentado total para amostra foi de 180 min/dia. As variáveis que após ajuste permaneceram associadas foram: escolaridade (razão de prevalência - RP = 1,41; intervalo de confiança de 95% - IC95% 1,35 - 1,48); estado civil (RP = 1,05; IC95% 1,02 - 1,08); segurança no bairro (RP = 0,96; IC95% 0,93 - 0,99); idade (RP = 0,91; IC95% 0,87 - 0,95); renda (RP = 1,07; IC95% 1,00 - 1,15); autopercepção de saúde (RP = 1,03; IC95% 1,01 - 1,07) e sexo (RP = 0,96; IC95% 0,94 - 0,99) Conclusão: Homens mais jovens, com mais escolaridade e renda, que residem em bairros considerados seguros, não casados e com autopercepção negativa de sua saúde estão entre os mais vulneráveis ao comportamento sedentário nessa população.


ABSTRACT: Introduction: The excessive sitting time involved in activities of low energy expenditure (sedentary behavior) can contribute to the development of chronic diseases. Assessing factors related to this behavior in a population is important to identify its most vulnerable segments. Objective: To describe sitting time distribution in the adult population of São Paulo City according to sociodemographic and environmental characteristics and health conditions. Methods: This is a cross-sectional study involving 2,512 individuals, aged 20 to 65 years, who participated in the Health Survey in the City of São Paulo (Inquérito de Saúde no Município de São Paulo - ISA-Capital) 2015. Data relating to sitting time were collected using the International Physical Activity Questionnaire (IPAQ), initially analyzed continuously, and, afterward, dichotomized by the median to analyze categorical variables. Results: The total sitting time median in the sample was 180 min/day. The variables that, after adjustments, remained related to sedentary behavior were: schooling (prevalence ratio - PR = 1.41; 95% confidence interval - 95%CI 1.35 - 1.48); marital status (PR = 1.05; 95%CI 1.02 - 1.08); neighborhood safety (PR = 0.96; 95%CI 0.93 - 0.99); age (PR = 0.91; 95%CI 0.87 - 0.95); income (PR = 1.07; 95%CI 1.00 - 1.15); self-rated health (PR = 1.03; 95%CI 1.01 - 1.07), and gender (PR = 0.96; 95%CI 0.94 - 0.99). Conclusion: The most vulnerable groups to sedentary behavior in this population are: younger males, with higher schooling and income, who live in neighborhoods considered safe, unmarried, and with negative self-rated health.

8.
Cad Saude Publica ; 34(12): e00034718, 2018 11 29.
Artigo em Português | MEDLINE | ID: mdl-30517313

RESUMO

The study aimed to validate self-report of high cholesterol in São Paulo, Brazil, and verify factors associated with this information's sensitivity. Data were used from the Health Survey of the City of São Paulo 2015, a cross-sectional population-based study with a probabilistic sample of the city's residents. The sample included 886 individuals with information from the structured questionnaire, blood measurements of total cholesterol and fractions or who reported being on medication for high cholesterol. The validity of self-reported information on high cholesterol was measured according to sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and kappa index, considering total cholesterol and LDL-c and pharmacological treatment as the gold standard. Logistic regression models were developed to investigate factors associated with the sensitivity of this information. The sensitivity of information on high cholesterol using total cholesterol as the reference was 50.6%, specificity 90.19%, PPV 51.64%, NPV 89.82%, and kappa 0.41. Taking LDL-c as the gold standard, sensitivity was 53.52%, specificity 89.93%, PPV 49.22%, NPV 91.39%, and kappa 0.43. Using total cholesterol as the reference, age (OR = 1.69; 95%CI: 1.24-2.29) and having a private health plan (OR = 2.91; 95%CI: 1.06-7.99) were associated with the information's sensitivity. With LDL-c as the gold standard, age (OR = 1.71; 95%CI: 1.13-2.57), smoking (OR = 3.33; 95%CI: 1.08-10.27), and having a private health plan (OR = 3.64; 95%CI: 1.10-12.08) were associated with the information's sensitivity. The results suggest low sensitivity and low PPV of self-reported high cholesterol in residents of São Paulo.


Assuntos
LDL-Colesterol , Hipercolesterolemia/diagnóstico , Autorrelato , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Hipercolesterolemia/epidemiologia , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Prevalência , Sensibilidade e Especificidade , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
9.
Cad Saude Publica ; 34(11): e00173317, 2018 11 23.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30484561

RESUMO

The aim of this study was to analyze prevalence rates and gender and age differences in indicators of active aging in elders participating in the Campinas Municipal Health Survey in Campinas, São Paulo State, Brazil (2014-2015). We estimated prevalence rates for participation by the elderly in twelve activities pertaining to four dimensions and calculated the prevalence ratios with Poisson regression. The study population consisted of 986 elderly. The results showed that 40.2% of the elderly participated in sociocultural activities, 25.3% were physically active in their leisure time, 21.7% used the Internet, 22.1% performed paid work, and only 2.6% were taking courses. In the social dimension, the only gender difference was in religious practice, which was less prevalent in men (PR = 0.67). In the dimension of physical activity, men were more active at work (PR = 2.10), in commuting (PR = 1.61), and in their leisure time (PR = 1.44). There was no gender difference in the intellectual dimension, and men were more active in paid work, (PR = 1.78). The analyses by age brackets showed that in men, only physical activity at work and paid work presented lower prevalence in the group eighty years and older. Among the oldest elderly women, lower prevalence rates were seen in six activities, which suggests a possible differential effect of advanced age between the sexes. The results show important rates of participation by elderly in some indicators of active aging, besides challenges in activities that are performed rarely and gender differences in participation.


Assuntos
Envelhecimento/fisiologia , Exercício/fisiologia , Estilo de Vida , Atividades Cotidianas , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Atividades de Lazer , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Transportes , Trabalho/fisiologia
10.
Cad Saude Publica ; 34(10): e00198717, 2018 10 22.
Artigo em Português | MEDLINE | ID: mdl-30365748

RESUMO

The objective was to compare the estimates for prevalence of diabetes, hypertension, and behavioral measures to control these diseases. Data were analyzed for the adult population from Health Surveys in the city of São Paulo, Brazil, in 2003, 2008, and 2015. Prevalence rates and 95% confidence intervals (95%CI) were calculated for the following: hypertension, diabetes, and practices to control these diseases (diet, physical activity, oral medication, insulin, nothing). Estimates were compared by age and sex-adjusted Poisson regression and analyzed according to the 20-59-years and 60-and-older age brackets. The data were presented comparing 2008 to 2003 and 2015 to 2003. Among persons 20 to 59 years of age, there was an increase in the prevalence rates for: hypertension in 2003-2015 (PR = 1.27; 95%CI: 1.03-1.60) and diet for both periods (2003-2008, PR = 2.04; 95%CI: 1.42-2.91; and 2003-2015, PR = 1.51; 95%CI: 1.05-2.15). Among persons 60 years and older: diabetes (PR = 1.29; 95%CI: 1.08-1.56) and oral medication to control diabetes (PR = 1.38; 95%CI: 1.17-1.63), both in 2003-2015; hypertension in 2003-2015 (PR = 1.19; 95%CI:1.05-1.39); and diet and oral medication to control hypertension in 2003-2008 (PR = 1.20; 95%CI: 0.95-1.51 and PR = 1.02; 95%CI: 0.95-1.09, respectively). The results are important for surveillance and monitoring of the target indicators and provide backing for planning health care activities in the city of São Paulo. Linking and aligning effective and integrated interventions is indispensable for reducing and controlling these chronic noncommunicable diseases.


Assuntos
Diabetes Mellitus/epidemiologia , Estilo de Vida Saudável , Hipertensão/epidemiologia , Adulto , Brasil/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos , Adulto Jovem
11.
Cad. Saúde Pública (Online) ; 34(10): e00198717, oct. 2018. tab
Artigo em Português | LILACS-Express | ID: biblio-974576

RESUMO

Resumo: O objetivo foi comparar as estimativas de prevalência de diabetes, hipertensão e as medidas de controle para estas doenças. Foram analisados dados de população adulta provenientes dos Inquéritos de Saúde no Município de São Paulo, Brasil, 2003, 2008 e 2015. Foram estimadas as prevalências e seus intervalos de 95% de confiança (IC95%) para as variáveis: hipertensão, diabetes e as práticas de controle para estas doenças (dieta alimentar, atividade física, medicamento oral, insulina, não faz nada). As estimativas foram comparadas por regressão de Poisson ajustada por sexo e idade, e analisadas segundo os domínios 20-59 e 60 anos e mais. Os dados foram apresentados comparando-se os anos de 2008 em relação a 2003 e 2015 em relação a 2003. Entre as pessoas de 20-59 anos, observou-se aumento nas prevalências de: hipertensão no período 2003-2015 (RP = 1,27; IC95%: 1,03-1,60) e dieta alimentar para ambos os períodos (2003-2008, RP = 2,04; IC95%: 1,42-2,91; e 2003-2015, RP = 1,51; IC95%: 1,05-2,15). Dentre as pessoas com 60 anos e mais: diabetes (RP = 1,29; IC95%: 1,08-1,56) e medicamento oral para controlar a diabetes (RP = 1,38; IC95%: 1,17-1,63), ambos no período 2003-2015; hipertensão no período 2003-2015 (RP = 1,19; IC95%: 1,05-1,39); e dieta alimentar e medicamento oral para controlar a hipertensão no período 2003-2008 (RP = 1,20; IC95%: 0,95-1,51 e RP = 1,02; IC95%: 0,95-1,09, respectivamente). Os resultados são importantes para a vigilância e monitoramento dos indicadores analisados, e fornecem subsídio ao planejamento de ações em saúde no Município de São Paulo. Articular e alinhar ações efetivas e integradas é imprescindível para a redução e controle dessas doenças.


Abstract: The objective was to compare the estimates for prevalence of diabetes, hypertension, and behavioral measures to control these diseases. Data were analyzed for the adult population from Health Surveys in the city of São Paulo, Brazil, in 2003, 2008, and 2015. Prevalence rates and 95% confidence intervals (95%CI) were calculated for the following: hypertension, diabetes, and practices to control these diseases (diet, physical activity, oral medication, insulin, nothing). Estimates were compared by age and sex-adjusted Poisson regression and analyzed according to the 20-59-years and 60-and-older age brackets. The data were presented comparing 2008 to 2003 and 2015 to 2003. Among persons 20 to 59 years of age, there was an increase in the prevalence rates for: hypertension in 2003-2015 (PR = 1.27; 95%CI: 1.03-1.60) and diet for both periods (2003-2008, PR = 2.04; 95%CI: 1.42-2.91; and 2003-2015, PR = 1.51; 95%CI: 1.05-2.15). Among persons 60 years and older: diabetes (PR = 1.29; 95%CI: 1.08-1.56) and oral medication to control diabetes (PR = 1.38; 95%CI: 1.17-1.63), both in 2003-2015; hypertension in 2003-2015 (PR = 1.19; 95%CI:1.05-1.39); and diet and oral medication to control hypertension in 2003-2008 (PR = 1.20; 95%CI: 0.95-1.51 and PR = 1.02; 95%CI: 0.95-1.09, respectively). The results are important for surveillance and monitoring of the target indicators and provide backing for planning health care activities in the city of São Paulo. Linking and aligning effective and integrated interventions is indispensable for reducing and controlling these chronic noncommunicable diseases.


Resumen: El objetivo fue comparar las estimativas de prevalencia de diabetes, hipertensión y las medidas de control para estas enfermedades. Se analizaron datos de población adulta, procedentes de encuestas de salud en el municipio de São Paulo, Brasil, de 2003, 2008 y 2015. Se estimaron las prevalencias y sus intervalos de 95% de confianza (IC 95%) para las variables: hipertensión, diabetes y prácticas de control para estas enfermedades (dieta alimentaria, actividad física, medicamento oral, insulina, no hacer nada). Las estimativas se compararon por regresión de Poisson, ajustada por sexo y edad, y se analizaron según los dominios 20-59 y 60 años o más. Los datos se presentaron comparándose los años de 2008, en relación a 2003, y 2015 en relación a 2003. Entre las personas de 20-59 años, se observó un aumento en las prevalencias de hipertensión durante el período 2003-2015 (RP = 1,27; IC95%: 1,03-1,60) y dieta alimentaria para ambos períodos (2003-2008, RP = 2,04; IC95%: 1,42-2,91; y 2003-2015, RP = 1,51; IC95%: 1,05-2,15). Entre las personas con 60 años o más: diabetes (RP: 1,29; IC95%: 1,08-1,56) y medicamento oral para controlar la diabetes (RP = 1,38; IC95%: 1,17-1,63), ambos durante el período 2003-2015; hipertensión durante el período 2003-2015 (RP = 1,19; IC95%: 1,05-1,39); además de dieta alimentaria y medicamento oral para controlar la hipertensión, durante el período 2003-2008 (RP = 1,20; IC95%: 0,95-1,51 y RP = 1,02; IC95%: 0,95-1,09, respectivamente). Los resultados son importantes para la vigilancia y monitoreo de los indicadores analizados, y proporcionan apoyo a la planificación de acciones en salud en el municipio de São Paulo. Coordinar y alinear acciones efectivas e integradas es imprescindible para la reducción y control de esas enfermedades.

12.
Rev Saude Publica ; 52: 81, 2018 Sep 03.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30183843

RESUMO

OBJECTIVE: To evaluate the sampling plan of the Health Survey of the City of São Paulo (ISA-Capital 2015) regarding the accuracy of estimates and the conformation of domains of study by the Health Coordinations of the city of São Paulo, Brazil. METHODS: We have described the population, domains of study, and sampling procedures, including stratification, calculation of sample size, and random selection of sample units, of the Health Survey of the City of São Paulo, 2015. The estimates of proportions were analyzed in relation to precision using the coefficient of variation and the design effect. We considered suitable the coefficients below 30% at the regional level and 20% at the city level and the estimates of the design effect below 1.5. We considered suitable the strategy of establishing the Health Coordinations as domains after verifying that, within the coordinations, the estimates of proportions for the age and sex groups had the minimum acceptable precision. The estimated parameters were related to the subjects of use of services, morbidity, and self-assessment of health. RESULTS: A total of 150 census tracts were randomly selected, 30 in each Health Coordination, 5,469 households were randomly selected and visited, and 4,043 interviews were conducted. Of the 115 estimates made for the domains of study, 97.4% presented coefficients of variation below 30%, and 82.6% were below 20%. Of the 24 estimates made for the total of the city, 23 presented coefficient of variation below 20%. More than two-thirds of the estimates of the design effect were below 1.5, which was estimated in the sample size calculation, and the design effect was below 2.0 for 88%. CONCLUSIONS: The ISA-Capital 2015 sample generated estimates at the predicted levels of precision at both the city and regional levels. The decision to establish the regional health coordinations of the city of São Paulo as domains of study was adequate.


Assuntos
Serviços de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos/métodos , Morbidade , Autoavaliação , Adolescente , Adulto , Brasil , Criança , Feminino , Humanos , Masculino , Amostragem , População Urbana , Adulto Jovem
13.
Rev Bras Epidemiol ; 21: e180011, 2018 Aug 20.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30133599

RESUMO

INTRODUCTION: The objective of this investigation was to check equity in coverage/complementation of health expenses by the Brazilian Unified Health System (SUS) for people with signs of common mental disorders, in 2008, in the city of São Paulo, Brazil. METHODS: Cross-sectional study with data from the 2008 São Paulo Health Survey. Individuals aged 16 or older and with signs of common mental disorders were selected and evaluated with the Self-Reporting Questionnaire (SRQ-20). The following aspects were analyzed: demand for SUS, coverage of health expenses by SUS, and health expenses in the previous month, withal according to sociodemographic and health conditions. RESULTS: The search for SUS services was lower among white people with higher per capita incomes, in a stable union, and with higher education degrees. Coverage by SUS was lower for people aged between 45 and 59 years and aged 60 years or older, with higher per capita incomes, with high or technical school, and college degrees. Subjects who spent more on family health were 60 years or older, white, with high per capita income, in a stable union, and with a college degree. CONCLUSIONS: Among people with signs of common mental disorders, SUS mainly services and covers the expenses of the poorer population with lower educational level; therefore coverage is unequal and favors who needs it the most. However, considering age, inequity became explicit, since SUS was shown to offer wider coverage of health expenses to the youngest population.


Assuntos
Gastos em Saúde , Transtornos Mentais/economia , Adolescente , Adulto , Brasil , Assistência à Saúde , Feminino , Disparidades em Assistência à Saúde/economia , Humanos , Masculino , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Saúde da População Urbana , Adulto Jovem
14.
Int J Equity Health ; 17(1): 72, 2018 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-29879999

RESUMO

BACKGROUND: Recent studies have explored the influence of socioeconomic inequalities on the diet quality. However, there is lack of evidence regarding the level of inequalities in dietary quality and its main contributing factors from population-based follow-up studies. The primary objective of this study was to investigate the level and the determinants of inequalities in diet quality in a representative sample of adolescents, adults and older adults resident in São Paulo, Brazil. METHODS: Data from the Health Survey of São Paulo (ISA-Capital) were analyzed for 2003 (n = 2398), 2008 (n = 1662) and 2015 (n = 1742) surveys. Information on food consumption was obtained through 24-h dietary recall, and diet quality was assessed based on the Revised Brazilian Healthy Eating Index (BHEI-R). The descriptive variables were compared using 95% confidence interval. The scores of BHEI-R and its components were compared across age groups and year. The association between socioeconomic inequalities and diet quality was based on the estimation of concentration index. RESULTS: We observed that the BHEI-R scores gradually improved over 12-years, with older adults showing the greatest improvement. The increase in overall population score was observed for total fruits, whole fruits, whole grains, oils and sodium. The main contributor to socioeconomic inequality in diet quality in 2003 was ethnic group, and in 2008 and 2015, it was per capita household income; age was a persistent factor of inequality in the population over the years. Concentration indices indicated that lower income individuals had higher BHEI-R scores in 2003; however, there was a shift in favor of higher income individuals in 2008 and 2015. CONCLUSIONS: Changes in the patterns of determination of inequalities according to age, ethnic group or income during the period analyzed show the existence of ongoing process of contribution of demographic and socioeconomic factors in the diet quality of individuals in a large urban center.


Assuntos
Dieta/normas , Grupos Étnicos , Renda , Pobreza , Adolescente , Adulto , Fatores Etários , Idoso , Brasil , Criança , Cidades , Estudos Transversais , Feminino , Alimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana , Adulto Jovem
15.
Epidemiol Serv Saude ; 27(2): e2017272, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29742237

RESUMO

OBJECTIVE: to estimate the vaccination coverage against influenza and pneumonia and to analyze the utilization of Brazilian National Health System-SUS for vaccination in adults and elderly with self-reported diabetes in São Paulo, Brazil, in 2003, 2008 and 2015. METHODS: Cross-sectional studies with data from the ISA-Capital (population-based household surveys). RESULTS: 3,357, 3,271 and 4,043 were interviewed in 2003, 2008 and 2015; the prevalence of diabetes mellitus were 5.0% (2003), 6.4% (2008) and 7.7% (2015); fewer than half of people with diabetes, vaccinated against influenza (47.2%) and pneumonia (17.9%) in 2003, with a small increase in 2015 (59.2% and 26.1%, respectively); the majority of people who are vaccinated against influenza and pneumonia used SUS, 88.7% (2003) and 97.2% (2015) for influenza; 84.7% (2003) and 94.5% (2015) for pneumonia, without difference among age, sex, education level and ethnicity. CONCLUSION: despite the low vaccination coverage against influenza and pneumonia in the population with diabetes mellitus since 2003 the utilization of SUS to vaccination has been progressively expanding.


Assuntos
Diabetes Mellitus/epidemiologia , Vacinas contra Influenza/administração & dosagem , Vacinas Pneumocócicas/administração & dosagem , Cobertura Vacinal/tendências , Adulto , Idoso , Brasil , Estudos Transversais , Feminino , Humanos , Influenza Humana/prevenção & controle , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Pneumonia Pneumocócica/prevenção & controle , Prevalência , Autorrelato , Vacinação/tendências , Adulto Jovem
16.
Artigo em Inglês | MEDLINE | ID: mdl-29538324

RESUMO

Food environment and income act as determinants of diet, and consequently, of the consumption of fruits and vegetables. The objective of this study is to investigate the association between fruit and vegetable consumption, income, and street market density in adolescents living in São Paulo, Brazil. Data from 521 adolescents (12 to 19 years) participating in the 2015 Health Survey of São Paulo were used. Buffers (500, 1000, and 1500 m) were drawn around the households and the street markets were counted in each zone. Multilevel logistic regression models were used to evaluate the association between fruit and vegetable consumption, income, and street market density. The main results showed that the presence of a street market in the zone closest to the households (500 m) was associated with higher consumption of fruits and vegetables (OR: 1.73; CI 95% 1.01-3.00). Higher family income was associated with a higher consumption of fruits and vegetables for models of 500 m buffer (OR: 2.56; CI 95% 1.47-4.45), 1000 m (OR: 2.30; CI 95% 1.33-3.96), and 1500 m (OR: 2.32; CI 95% 1.35-4.00). These results support the implementation of public policies that jointly consider income and the availability of street markets or healthy food environments.


Assuntos
Dieta/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Renda/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Adolescente , Brasil , Estudos Transversais , Inquéritos sobre Dietas , Meio Ambiente , Feminino , Frutas , Humanos , Modelos Logísticos , Masculino , Verduras
17.
Artigo em Inglês | MEDLINE | ID: mdl-29561755

RESUMO

Cities that support cycling for transportation reap many public health benefits. However, the prevalence of this mode of transportation is low in Latin American countries and the association with facilities such as bike paths and train/subway stations have not been clarified. We conducted a cross-sectional analysis of the relationship between bike paths, train/subway stations and cycling for transportation in adults from the city of Sao Paulo. We used data from the Sao Paulo Health Survey (n = 3145). Cycling for transportation was evaluated by a questionnaire and bike paths and train/subway stations were geocoded using the geographic coordinates of the adults' residential addresses in 1500-m buffers. We used multilevel logistic regression, taking account of clustering by census tract and households. The prevalence of cycling for transportation was low (5.1%), and was more prevalent in males, singles, those active in leisure time, and in people with bicycle ownership in their family. Cycling for transportation was associated with bike paths up to a distance of 500 m from residences (OR (Odds Ratio) = 2.54, 95% CI (Confidence interval) 1.16-5.54) and with the presence of train/subway stations for distances >500 m from residences (OR = 2.07, 95% CI 1.10-3.86). These results are important to support policies to improve cycling for transportation in megacities such as Sao Paulo.


Assuntos
Ciclismo/estatística & dados numéricos , Transportes/métodos , Transportes/estatística & dados numéricos , Adulto , Fatores Etários , Brasil , Cidades , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Saúde Pública , Ferrovias/estatística & dados numéricos , Fatores Sexuais , Adulto Jovem
18.
Cad. Saúde Pública (Online) ; 34(11): e00173317, 2018. tab
Artigo em Português | LILACS-Express | ID: biblio-974585

RESUMO

O objetivo deste estudo foi analisar as prevalências e as diferenças de gênero e idade em indicadores de envelhecimento ativo entre idosos participantes do Inquérito de Saúde do Município de Campinas, São Paulo, Brasil, 2014-2015. Estimaram-se as prevalências de participação dos idosos em doze atividades relativas a quatro dimensões, e as razões de prevalência foram calculadas pela regressão de Poisson. A população de estudo foi composta por 986 idosos. Os resultados revelaram que 40,2% dos idosos participavam de atividades socioculturais, 25,3% eram fisicamente ativos no lazer, 21,7% usavam a Internet, 22,1% exerciam trabalho remunerado e apenas 2,6% realizavam cursos. Quanto à dimensão social, só houve diferença entre os sexos na frequência aos cultos religiosos, sendo menos prevalente entre os homens (RP = 0,67). Na dimensão da atividade física, os homens eram mais ativos no trabalho (RP = 2,10), no deslocamento (RP = 1,61) e no lazer (RP = 1,44). Na dimensão intelectual, não houve diferença entre os sexos e, em relação ao trabalho remunerado, os homens eram mais ativos (RP = 1,78). As análises segundo faixas etárias evidenciaram que, entre os homens, apenas a prática de atividade física no trabalho e o exercício de trabalho remunerado apresentaram menor prevalência no grupo de 80 anos e mais. Entre as mulheres mais longevas, foram identificadas menores prevalências em seis atividades, o que sinaliza possível efeito diverso do avanço da idade entre os sexos. Os resultados revelam expressiva participação dos idosos em alguns dos indicadores do envelhecimento ativo e os desafios no que concerne às atividades pouco realizadas e às diferenças de participação entre os sexos.


El objetivo de este estudio fue analizar las tasas de prevalencia y las diferencias de género y edad en los indicadores de envejecimiento activo en adultos mayores que participan en la Encuesta de Salud del Municipio de Campinas, estado de São Paulo, Brasil (2014-2015). Estimamos las tasas de prevalencia para la participación de los ancianos en doce actividades relacionadas con cuatro dimensiones y calculamos las tasas de prevalencia con la regresión de Poisson. La población de estudio consistió en 986 ancianos. Los resultados mostraron que el 40,2% de los adultos mayores participaban en actividades socioculturales, el 25,3% era físicamente activo en su tiempo libre, el 21,7% utilizaba Internet, el 22,1% realizaba trabajo remunerado y solo el 2,6% asistía a cursos. En la dimensión social, la única diferencia de género estaba en la práctica religiosa, que era menos frecuente en los hombres (RP = 0,67). En la dimensión de la actividad física, los hombres eran más activos en el trabajo (PR = 2,10), en los desplazamientos diarios (PR = 1,61) y en su tiempo libre (PR = 1,44). No hubo diferencia de género en la dimensión intelectual, y los hombres eran más activos en el trabajo remunerado, (PR = 1,78). Los análisis por grupos de edad mostraron que en los hombres, solo la actividad física en el trabajo y el trabajo remunerado presentaron una prevalencia más baja en el grupo de 80 años y más. Entre las mujeres ancianas de mayor edad, se observaron tasas de prevalencia más bajas en seis actividades, lo que sugiere un posible efecto diferencial de la edad avanzada entre los sexos. Los resultados muestran tasas importantes de participación de personas mayores en algunos indicadores de envejecimiento activo, además de desafíos en actividades que se realizan con poca frecuencia y diferencias de género en la participación.


The aim of this study was to analyze prevalence rates and gender and age differences in indicators of active aging in elders participating in the Campinas Municipal Health Survey in Campinas, São Paulo State, Brazil (2014-2015). We estimated prevalence rates for participation by the elderly in twelve activities pertaining to four dimensions and calculated the prevalence ratios with Poisson regression. The study population consisted of 986 elderly. The results showed that 40.2% of the elderly participated in sociocultural activities, 25.3% were physically active in their leisure time, 21.7% used the Internet, 22.1% performed paid work, and only 2.6% were taking courses. In the social dimension, the only gender difference was in religious practice, which was less prevalent in men (PR = 0.67). In the dimension of physical activity, men were more active at work (PR = 2.10), in commuting (PR = 1.61), and in their leisure time (PR = 1.44). There was no gender difference in the intellectual dimension, and men were more active in paid work, (PR = 1.78). The analyses by age brackets showed that in men, only physical activity at work and paid work presented lower prevalence in the group eighty years and older. Among the oldest elderly women, lower prevalence rates were seen in six activities, which suggests a possible differential effect of advanced age between the sexes. The results show important rates of participation by elderly in some indicators of active aging, besides challenges in activities that are performed rarely and gender differences in participation.

19.
Cad. Saúde Pública (Online) ; 34(12): e00034718, 2018. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-974612

RESUMO

O objetivo do presente estudo foi validar a autorreferência de colesterol elevado em residentes de São Paulo, Brasil, e verificar os fatores associados à sensibilidade dessa informação. Foram utilizados dados do Inquérito de Saúde de São Paulo de 2015, estudo transversal de base populacional com amostra probabilística de residentes do município. Foram incluídos 886 indivíduos com informações do questionário estruturado, dosagem de colesterol total e frações ou que referiram tratamento farmacológico do colesterol elevado. A validade da informação autorreferida de colesterol elevado foi determinada por meio da sensibilidade, especificidade, valores preditivos positivo (VPP) e negativo (VPN) e kappa, considerando as dosagens de colesterol total e LDL-c e o tratamento farmacológico como padrão-ouro. Modelos de regressão logística foram realizados a fim de investigar os fatores associados à sensibilidade dessa informação. A sensibilidade da informação de colesterol elevado tendo em conta o colesterol total como referência foi de 50,6%, a especificidade de 90,19%, VPP de 51,64%, VPN de 89,82% e kappa de 0,41. Considerando o LDL-c como padrão-ouro, a sensibilidade foi 53,52%, a especificidade 89,93%, o VPP 49,22%, o VPN 91,39% e kappa 0,43. Utilizando a dosagem de colesterol total como referência, a idade (OR = 1,69; IC95%: 1,24-2,29) e o plano de saúde (OR = 2,91; IC95%: 1,06-7,99) se associaram à sensibilidade dessa informação. Considerando a dosagem de LDL-c como padrão-ouro, a idade (OR = 1,71; IC95%: 1,13-2,57), o tabagismo (OR = 3,33; IC95%: 1,08-10,27) e o plano de saúde (OR = 3,64; IC95%: 1,10-12,08) foram associados à sensibilidade dessa informação. Os resultados indicam baixa sensibilidade e VPP da autorreferência do colesterol elevado em residentes de São Paulo.


The study aimed to validate self-report of high cholesterol in São Paulo, Brazil, and verify factors associated with this information's sensitivity. Data were used from the Health Survey of the City of São Paulo 2015, a cross-sectional population-based study with a probabilistic sample of the city's residents. The sample included 886 individuals with information from the structured questionnaire, blood measurements of total cholesterol and fractions or who reported being on medication for high cholesterol. The validity of self-reported information on high cholesterol was measured according to sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and kappa index, considering total cholesterol and LDL-c and pharmacological treatment as the gold standard. Logistic regression models were developed to investigate factors associated with the sensitivity of this information. The sensitivity of information on high cholesterol using total cholesterol as the reference was 50.6%, specificity 90.19%, PPV 51.64%, NPV 89.82%, and kappa 0.41. Taking LDL-c as the gold standard, sensitivity was 53.52%, specificity 89.93%, PPV 49.22%, NPV 91.39%, and kappa 0.43. Using total cholesterol as the reference, age (OR = 1.69; 95%CI: 1.24-2.29) and having a private health plan (OR = 2.91; 95%CI: 1.06-7.99) were associated with the information's sensitivity. With LDL-c as the gold standard, age (OR = 1.71; 95%CI: 1.13-2.57), smoking (OR = 3.33; 95%CI: 1.08-10.27), and having a private health plan (OR = 3.64; 95%CI: 1.10-12.08) were associated with the information's sensitivity. The results suggest low sensitivity and low PPV of self-reported high cholesterol in residents of São Paulo.


El objetivo de este estudio fue validar el autoinforme de colesterol elevado en residentes de São Paulo, Brasil, y verificar los factores asociados a la sensibilidad de esta información. Se utilizaron datos de la Encuesta de Salud de São Paulo 2015, estudio transversal de base poblacional con una muestra probabilística de residentes del municipio. Se incluyeron 886 individuos con información del cuestionario estructurado, cantidad de colesterol total y fracciones o que informaron de un tratamiento farmacológico por colesterol elevado. La validez de la información autoinformada de colesterol elevado fue determinada por medio de la sensibilidad, especificidad, valores predictivos positivo (VPP) y negativo (VPN) y kappa, considerando las cantidades de colesterol total y LDL-c y el tratamiento farmacológico como parámetro de referencia. Se realizaron modelos de regresión logística, a fin de investigar los factores asociados a la sensibilidad de esa información. La sensibilidad de la información de colesterol elevado, teniendo en cuenta el colesterol total como referencia, fue de un 50,6%, la especificidad de 90,19%, VPP de 51,64%, VPN de 89,82% y kappa de 0,41. Considerando el LDL-c como parámetro de referencia, la sensibilidad fue 53,52%, la especificidad 89,93%, el VPP 49,22%, el VPN 91,39% y kappa 0,43. Utilizando la cantidad de colesterol total como referencia, la edad (OR = 1,69; IC95%: 1,24-2,29) y el plan de salud (OR = 2,91; IC95%: 1,06-7,99) se asociaron a la sensibilidad de esa información. Considerando la cantidad de LDL-c como parámetro de referencia, la edad (OR = 1,71; IC95%: 1,13-2,57), el tabaquismo (OR = 3,33; IC95%: 1,08-10,27) y el plan de salud (OR = 3,64; IC95%: 1,10-12,08) se asociaron a la sensibilidad de esa información. Los resultados indican baja sensibilidad y VPP del autoinforme de colesterol elevado en residentes de São Paulo.

20.
Rev. bras. epidemiol ; 21: e180011, 2018. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-958828

RESUMO

RESUMO: Introdução: O objetivo deste trabalho foi verificar a equidade na cobertura/complementação dos gastos com saúde pelo Sistema Único de Saúde (SUS) de pessoas com indicativos de transtornos mentais comuns (TMC), no ano de 2008, no município de São Paulo. Métodos: Foi realizado um estudo de corte transversal a partir dos dados do Inquérito de Saúde no Município de São Paulo de 2008 (ISA-Capital 2008). Os sujeitos incluídos na pesquisa tinham 16 anos de idade ou mais e indicativos de TMC, avaliados por meio do instrumento Self-Reporting Questionnaire (SRQ-20). Foram analisados: a procura pelo SUS, a cobertura dos gastos com saúde pelo SUS e os gastos com saúde no último mês, correlacionando-os com aspectos sociodemográficos e de condições de saúde. Resultados: A procura pelo SUS foi menor entre as pessoas de cor branca, renda per capita elevada, com união estável e Ensino Superior. A cobertura pelo SUS foi menor entre as faixas etárias de 45 a 59 anos e de 60 anos ou mais, com renda per capita elevada, Ensino Médio ou Técnico e Ensino Superior. As pessoas que gastaram mais com a saúde da família foram aquelas com idade igual ou superior a 60 anos, de cor branca, renda per capita mais elevada, com união estável e Ensino Superior. Conclusões: Foi observado que o SUS atende e cobre os gastos majoritariamente daqueles com renda per capita e escolaridade mais baixas, denotando uma cobertura desigual que favorece os mais necessitados. Porém, considerando o fator idade, ficou explícita uma situação de iniquidade, pois foi constatada maior cobertura dos gastos em saúde pelo SUS para a população mais jovem.


ABSTRACT: Introduction: The objective of this investigation was to check equity in coverage/complementation of health expenses by the Brazilian Unified Health System (SUS) for people with signs of common mental disorders, in 2008, in the city of São Paulo, Brazil. Methods: Cross-sectional study with data from the 2008 São Paulo Health Survey. Individuals aged 16 or older and with signs of common mental disorders were selected and evaluated with the Self-Reporting Questionnaire (SRQ-20). The following aspects were analyzed: demand for SUS, coverage of health expenses by SUS, and health expenses in the previous month, withal according to sociodemographic and health conditions. Results: The search for SUS services was lower among white people with higher per capita incomes, in a stable union, and with higher education degrees. Coverage by SUS was lower for people aged between 45 and 59 years and aged 60 years or older, with higher per capita incomes, with high or technical school, and college degrees. Subjects who spent more on family health were 60 years or older, white, with high per capita income, in a stable union, and with a college degree. Conclusions: Among people with signs of common mental disorders, SUS mainly services and covers the expenses of the poorer population with lower educational level; therefore coverage is unequal and favors who needs it the most. However, considering age, inequity became explicit, since SUS was shown to offer wider coverage of health expenses to the youngest population.

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