Avaliação de indicadores sociais e de saúde em municípios de Minas Gerais conforme tipologia rural-urbano / Assessment of social and health indicators in municipalities of Minas Gerais according to the rural-urban typology

RESUMO O presente artigo tem o objetivo de avaliar indicadores sociais e de saúde de municípios conforme a tipologia rural-urbano. Trata-se de estudo ecológico que utilizou dados oficiais de acesso público dos 853 municípios do estado de Minas Gerais, Brasil. Foram conduzidas análises descritivas e bivariadas através da Regressão de Poisson e Teste de Kruskal-Wallis. Do total de municípios, 547 (64,12%) são rurais. A maior média do Índice de Desenvolvimento Humano Municipal (IDH-M) foi observada entre os municípios urbanos. A maior média de cobertura da Estratégia Saúde da Família (ESF) foi verificada entre os municípios rurais, nos quais também foram demonstrados os melhores resultados para os indicadores de mortalidades infantil, prematura e por causas evitáveis, homogeneidade vacinal e prevalência de desnutrição. Os achados deste estudo evidenciam que uma maior cobertura da ESF está associada à ocorrência de melhores condições gerais de vida e de saúde das populações atendidas em municípios de tipologia rural. Recomenda-se aos gestores de saúde o fomento à consolidação da ESF em comunidades com contextos socioeconômicos e culturais desfavoráveis, como localidades rurais remotas e aglomerados urbanos, e o estabelecimento de ações intersetoriais com impacto positivo na saúde.

ABSTRACT This article aims to evaluate social and health indicators of municipalities according to the rural-urban typology. This is an ecological study that used official publicly accessible data from the 853 municipalities in the state of Minas Gerais, Brazil. Descriptive and bivariate analysis were carried out using Poisson Regression and Kruskal-Wallis Test. 547 (64.12%) are rural municipalities. The highest average of the Municipal Human Development Index (MHDI) was observed among urban municipalities. The highest average coverage of the Family Health Strategy (FHS) was found among rural municipalities. In these municipalities, the best results were shown for the indicators of infant mortality, premature mortality and mortality from preventable causes, vaccine homogeneity and prevalence of malnutrition. The findings of this study show that greater FHS coverage is associated with the occurrence of better general living and health conditions in the populations served in rural municipalities. It is recommended that health managers encourage the consolidation of the FHS in communities with unfavorable socioeconomic and cultural contexts, such as remote rural locations and urban agglomerations, and the establishment of intersectoral actions with a positive impact on health.

Relación entre indicadores de desarrollo social y mortalidad por Diabetes Mellitus en Brasil: análisis espacial y temporal / Relationship between social development indicators and mortality due to Diabetes Mellitus in Brazil: a space-time analysis / Relação indicadores de desenvolvimento social e mortalidade por diabetes mellitus no Brasil: análise espacial e temporal

Objetivo: identificar el patrón espacial y temporal de la mortalidad por Diabetes Mellitus en Brasil y su relación con los indicadores de desarrollo social. Método: estudio ecológico y de series temporales, a nivel nacional, con base en datos secundarios del Departamento de Informática del Sistema Único de Salud, con análisis espacial y temporal e inserción de indicadores en modelos de regresión no espacial y espacial. Se realizaron: cálculo de la tasa de mortalidad general; caracterización del perfil sociodemográfico y regional de las muertes mediante análisis descriptivo y temporal; y elaboración de mapas temáticos. Resultados: en Brasil se registraron 601.521 muertes relacionadas con la Diabetes Mellitus, lo que representa una mortalidad media de 29,5/100.000 habitantes. Los estados de Rio Grande do Norte, Paraíba, Pernambuco, Alagoas y Sergipe, Río de Janeiro, Paraná y Rio Grande do Sul presentaron conglomerados alto-alto. Mediante el uso de modelos de regresión, se comprobó que el índice de Gini (β=11,7) y la cobertura de la Estrategia Salud de la Familia (β=3,9) fueron los indicadores que más influyeron en la mortalidad por Diabetes Mellitus en Brasil. Conclusión: la mortalidad por diabetes en Brasil tiene una tendencia general alcista, está fuertemente asociada a los lugares con peores indicadores sociales.

Objective: to identify the space-time pattern of mortality due to Diabetes Mellitus in Brazil, as well as its relationship with social development indicators. Method: an ecological and time series nationwide study based on secondary data from the Unified Health System Informatics Department, with space-time analysis and inclusion of indicators in non-spatial and spatial regression models. The following was performed: overall mortality rate calculation; characterization of the sociodemographic and regional profiles of the death cases by means of descriptive and time analysis; and elaboration of thematic maps. Results: a total of 601,521 deaths related to Diabetes Mellitus were recorded in Brazil, representing a mean mortality rate of 29.5/100,000 inhabitants. The states of Rio Grande do Norte, Paraíba, Pernambuco, Alagoas and Sergipe, Rio de Janeiro, Paraná and Rio Grande do Sul presented high-high clusters. By using regression models, it was verified that the Gini index (β=11.7) and the Family Health Strategy coverage (β=3.9) were the indicators that most influenced mortality due to Diabetes Mellitus in Brazil. Conclusion: in Brazil, mortality due to Diabetes presents an overall increasing trend, revealing itself as strongly associated with places that have worse social indicators.

Objetivo: identificar o padrão espacial e temporal da mortalidade por diabetes mellitus, no Brasil, e sua relação com indicadores de desenvolvimento social. Método: estudo ecológico e de séries temporais, de abrangência nacional, com base em dados secundários do Departamento de Informática do Sistema Único de Saúde, com análise espacial e temporal e inserção de indicadores em modelos de regressão não espacial e espacial. Realizaram-se: cálculo da taxa de mortalidade geral; caracterização do perfil sociodemográfico e regional dos óbitos mediante análise descritiva e temporal; e construção de mapas temáticos. Resultados: foram registrados 601.521 óbitos relacionados ao diabetes mellitus no Brasil, representando mortalidade média de 29,5/100.000 habitantes. Os estados do Rio Grande do Norte, Paraíba, Pernambuco, Alagoas e Sergipe, Rio de Janeiro, Paraná e Rio Grande do Sul apresentaram aglomerados alto-alto. Por meio do uso de modelos de regressão, verificou-se que o índice Gini (β=11,7) e a cobertura da Estratégia de Saúde da Família (β=3,9) foram os indicadores que mais influenciaram a mortalidade por diabetes mellitus no Brasil. Conclusão: a mortalidade por diabetes, no Brasil, exibe tendência geral ascendente, revelando-se fortemente associada a locais com piores indicadores sociais.

Sustainable transportation: Definitions, dimensions, and indicators - Case study of importance-performance analysis for the city of Tehran.

Despite the advantages of transportation development, its negative consequences, including greenhouse gas (GHG) emissions, air pollution, increasing energy consumption, traffic, and accidents in transportation, have caused serious concern in the world community. Following the global efforts to introduce the framework for sustainable development (SD), the sustainability concept entered the transportation of literature known as sustainable transportation (ST). We didn't find a universally agreed definition and indicators for (ST). To overcome this limitation, we extracted special terms in different definitions of (ST) and widely used indicators in selected articles. Using 60 widely used indicators and the importance-performance analysis (IPA) method, we evaluated the transportation of Tehran. Like some metropolises, Tehran city has high air and noise pollution, congestion, traffic, and accidents. The main advantage of our research is the possibility to simultaneously assess the importance, performance, and prioritize performance of indicators for improvement, with optimal cost and time. Our evaluation showed that 41 indicators (68.34%) have high importance, but their performance is low and should be improved. 80% of these indicators were related to social and environmental dimensions. We prioritized Tehran's transportation indicators and provided recommendations to improve their performance. Prioritizing indicators showed that improving the performance of Tehran's transportation, reducing natural resource consumption, attention to human health, and reducing energy consumption have high priority. Finally, we have provided a comprehensive definition (ST) of widely used terms.

The Social Factors Influencing Cover Crop Adoption in the Midwest: A Controlled Comparison.

Increased funding and resources have become available in recent years for agricultural producers to plant cover crops to improve soil health and prevent nutrient loss and erosion; however, cover crop adoption remains relatively low and has been uneven across different Midwestern counties. This study employed a controlled comparison method to investigate the social factors affecting cover crop adoption in Iowa, Illinois, and Indiana. In each state, the authors compared pairs of neighboring counties, where one county was a relatively higher adopter and the other was a lower adopter of cover crops, while controlling for variations in climate conditions. Results show that there were multiple factors explaining the difference in cover crop adoption among county pairs. Social factors included attitudes toward cover crops; conservation agency influence; presence of cover crop experts, advocates, and/or entrepreneurs; and collaboration between agencies and the private sector. Other important factors included topography, cattle raising, organic production, and local incentive-based programs. Among these, collaborations between agencies and the private sector played the most important role in explaining why some counties had higher rates of cover crop adoption compared to their neighbors.

Social indicators with serious injury and school bullying victimization in vulnerable adolescents aged 12-15 years: Data from the Global School-Based Student Survey.

OBJECTIVE: The prevalence rates of injury and bullying victimization in adolescents are continuing to rise; however, little is known about the influence of social determinants, especially for vulnerable adolescents. We aimed to estimate the prevalence of serious injury and bullying victimization in vulnerable adolescents with mental health issues or poor social support and examine the associations between social indicators and these two outcomes. METHOD: We used the most recent datasets from the Global School-based Student Health Survey, and vulnerable adolescents aged 12-15 years from 54 countries were included. The pooled overall and regional estimates were obtained by random-effects models. Multivariable logistic regression was performed to estimate the adjusted association between five common social indicators and the two outcomes. Dose-response association was estimated by using a restricted cubic spline. RESULTS: The prevalence rates of serious injury and bullying victimization were high in vulnerable adolescents, with apparent variation between regions and countries. The pooled prevalence of serious injury ranged from 45.10 % to 50.11 %, whereas the pooled prevalence of bullying victimization ranged from 35.54 % to 45.21 %. Social indicators of national wealth, health status, income and gender inequality were significantly associated with the prevalence of serious injury and bullying victimization in vulnerable adolescents. CONCLUSIONS: Serious injury and school bullying victimization are prevalent in vulnerable adolescents aged 12-15 years. Social indicators were prominent associated factors of serious injury and bullying victimization in vulnerable adolescents. The results emphasize the importance of social environment when developing intervention measures to address injury and bullying among disadvantaged teenagers.

Associação de fatores sociais e orçamentários ao acesso ao cuidado em saúde bucal de grandes municípios brasileiros: um estudo ecológico / Association of social and budgetary factors with access to oral health care in large Brazilian municipalities: an ecological study

Objetivo: Analisar a associação do acesso a ações preventivas em saúde bucal e do tratamento mutilador, ofertado pelos serviços públicos de grandes municípios brasileiros, com as suas características sociais e a composição orçamentária. Metodologia: Realizou-se um estudo ecológico com dados secundários de 323 municípios brasileiros com mais de 100 mil habitantes. As variáveis selecionadas para estudo foram os indicadores sociais (desigualdade social, renda, trabalho, escolaridade, infraestrutura sanitária), indicadores orçamentários (capacidade arrecadatória, dependência de recursos federais) e indicadores de saúde bucal (cobertura de equipes básicas de saúde bucal, acesso a ações preventivas e acesso a tratamento mutilador). Os dados dos indicadores de saúde bucal foram dicotomizados entre municípios com maior e menor acesso às ações preventivas ou ao tratamento mutilador. A associação das variáveis dependentes foi testada por meio de testes bivariados e regressão logística. Resultados: Um maior acesso às ações preventivas foi observado nos municípios com melhores condições sociais e orçamentárias. Por outro lado, um maior acesso ao tratamento mutilador foi observado em municípios com condições sociais orçamentárias inferiores. Conclusão: Apenas a infraestrutura sanitária e cobertura de equipes básicas de saúde bucal se mantiveram associados ao acesso às ações preventivas, enquanto o indicador de desigualdade social manteve-se associado ao tratamento mutilador. Descritores: indicadores sociais; disparidades nos níveis de saúde; mensuração das desigualdades em saúde; financiamento governamental.Associação de fatores sociais e orçamentários ao acesso ao cuidado em saúde bucal de grandes municípios brasileiros: um estudo ecológico

Aim: To analyze the correlation of access to preventive oral health measures and mutilating treatment, offered by the public health system of large Brazilian municipalities, considering social conditions and budgetary compositions. Methods:An ecological study was carried out with secondary data from 323 Brazilian municipalities with more than 100,000 inhabitants. The variables selected for the study were social indicators (social inequality, income, work, education, sanitary infrastructure); budget indicators (collection capacity, dependence on federal resources); and oral health indicators (coverage of basic oral health teams, access to preventive actions, and access to mutilating treatment). Oral health indicators were dichotomized between municipalities with higher and lower access to preventive oral health measures and mutilating treatment. The association of dependent variables was tested using bivariate tests and logistic regression. Results: Higher access to preventive measures was observed in municipalities with better social and budgetary conditions. By contrast, higher access to mutilating treatment was observed in municipalities with lower social budgetary conditions. Conclusion: Only health infrastructure and coverage of basic oral health teams remained associated with access to preventive actions, while the indicator of social inequality remained associated with mutilating treatment.

Correlação entre indicadores de desenvolvimento municipal e de saúde bucal em uma mesorregião metropolitana do Brasil / Correlation between municipal development indicators and oral health in a Brazilian metropolitan mesoregion

Resumo Introdução O estudo da relação entre indicadores sociais e indicadores de saúde bucal pode contribuir para a avaliação dos impactos das políticas e ações de saúde. Objetivo Investigar a correlação entre indicadores de desenvolvimento municipal e indicadores de saúde bucal dos municípios integrantes da mesorregião metropolitana de Curitiba, Paraná, Brasil. Método Estudo epidemiológico do tipo ecológico, por meio de dados referentes ao Índice de Desenvolvimento Humano Municipal (IDHM) do ano 2010, obtidos no portal Atlas Brasil; Índice Ipardes de Desempenho Municipal (IPDM) dos anos 2015 e 2016, obtidos no portal do Ipardes; e indicadores de saúde bucal dos anos 2015 a 2018, oriundos do SIA/SUS. Posteriormente, foi empregado o teste de correlação de Spearman. Resultados Verificou-se correlação positiva estatisticamente significativa entre indicadores de desenvolvimento municipal e indicadores de primeira consulta odontológica programática no ano de 2017; correlação negativa entre IDHMs e exodontias nos anos de 2015 e 2016; correlação positiva entre IPDMs e procedimentos odontológicos individuais básicos dos anos 2015 a 2018. Conclusão Houve correlação significativa entre os indicadores de desenvolvimento municipal e os indicadores de saúde bucal. Municípios com maiores índices de desenvolvimento proporcionaram maior acesso aos serviços de saúde bucal e menores proporções de exodontias por habitante.

Abstract Background The study of the correlation between social and oral health indicators can contribute to evaluating the impacts of health policies and actions. Objective To investigate the correlation between municipal development indicators and oral health indicators in the metropolitan region of Curitiba, Paraná, Brazil. Method Epidemiological study of the ecological type was carried out, using data from the Municipal Human Development Index (MHDI) of the year 2010, obtained from the Atlas Brasil portal; Ipardes Municipal Performance Index (IPDM) of the years 2015 and 2016, obtained from the Ipardes portal; and oral health indicators from 2015 to 2018, from SIA/SUS. Subsequently, the Spearman correlation test was used. Results There was a statistically significant positive correlation between municipal development indicators and indicators of the first programmatic dental consultation in 2017; a negative correlation between MHDI and tooth extractions, in the years 2015 and 2016; a positive correlation between IPDM and basic individual dental procedures from the years 2015 to 2018. Conclusion There was a significant correlation between the municipal development indicators and the oral health indicators. Municipalities with higher development rates provided greater access to oral health services and lower proportions of tooth extractions per inhabitant.

Relationship between microcephaly and indicators of social inequality in the state of Paraíba, Brazil

ABSTRACT Objective To analyze the relationship between microcephaly and social inequality indicators in the state of Paraíba during the biennium January 2015 and December 2016. Methods Ecological study with data from newborn microcephaly records and municipal socioeconomic, environmental, and demographic indicators was conducted using two health information systems from the Brazilian Ministry of Health (SINASC and SINAN) and the Brazilian Institute of Geography and Statistics. A Poisson multiple regression model was applied with a significance level of 5%. Results Among 223 municipalities in Paraíba, 74 registered new cases of microcephaly. The number of Zika virus cases, number of inhabitants, number of households without adequate water supply, and household income were predictor variables of the number of new cases of microcephaly in Paraíba. Conclusion Microcephaly is associated with indicators of social inequality in Paraíba. Zika virus cases, water supply, and family income are the indicators that best explain the increase in microcephaly cases. Therefore, these variables must be monitored by health professionals and authorities.

Measuring the social determinants of health: an integrative literature review / Medición de los determinantes sociales de la salud: revisión documental integrativa / Medindo os determinantes sociais da saúde: uma revisão integrativa da literature

AВSTRАСT Introduction: The Social Determinants of Health are those conditions that directly or indirectly influence the life course, the health of individuals and inequalities. Objective: to analyze the scientific evidence on instruments used to measure the Social Determinants of Health. Method: integrative documentary review of publications on this topic in 27 scientific articles, analyzed in ATLAS.ti software. Results: 2019 was the year with the highest number of studies related to Social Determinants of Health, English the predominant language; the United States is the most prolific country in publications; the most evaluated were the health system (70%), education (63%), economic income and housing (55%). Age, gender and ethnicity were assessed in 41%, socioeconomic stratum was not directly assessed. The measurement has been focused on the structural. Conclusion: according to scientific evidence, there is no homogeneity to include in instruments the fundamental Social Determinants of Health that explain inequalities and inequities and the design of generic instruments is an international need to evaluate the structural and intermediate determinants.

RESUMEN Introducción: los Determinantes Sociales de la Salud son aquellas condiciones que directa o indirectamente influyen en el curso de vida, la salubridad de los individuos y las desigualdades. Objetivo: analizar la evidencia científica sobre instrumentos utilizados para la medición de los Determinantes Sociales de la Salud. Material y método: revisión documental integrativa de publicaciones referentes a este tema en 27 artículos científicos, analizados en software ATLAS.ti. Resultados: el ano 2019 fue el de mayor número de estudios relacionados con Determinantes Sociales de la Salud, inglés el idioma predominante; Estados Unidos es el país más prolífico en publicaciones; los mayormente evaluados fueron el sistema de salud (70%), educación (63%), ingresos económicos y vivienda (55%). La edad, género y etnia se evaluaron en un 41%, el estrato socioeconómico no se evaluó directamente. La medición se ha centrado en lo estructural. Conclusión: según la evidencia científica no existe homogeneidad para incluir en instrumentos los Determinantes Sociales de la Salud fundamentales que explican las desigualdades e inequidades y el diseno de instrumentos genéricos es una necesidad internacional para evaluar los determinantes estructurales e intermedios.

RESUMO Introdução: os Determinantes Dociais da Daúde são as condições que influenciam directa ou indirectamente o curso da vida, a saúde dos indivíduos e as desigualdades. Objectivo: analisar as provas científicas sobre os instrumentos utilizados para medir os Determinantes Dociais da Daúde. Método: revisão documental integrativa de publicações sobre este tema em 27 artigos científicos, utilizando o software de análise estatística ATLAS.ti. Resultados: 2019 foi o ano com o maior número de estudos relacionados com Determinantes Sociais da Saúde, sendo o inglês a língua predominante; os Estados Unidos são o país mais prolífico em publicações. Entre as variáveis mais avaliadas estão o sistema de saúde (70%), educação (63%) e rendimento económico e habitação (55%). A idade, género e etnia foram avaliados em 41%, o estrato socioeconómico não foi directamente avaliado. A medição centra-se nos aspectos estruturais. Conclusão: de acordo com provas científicas não existe homogeneidade para incluir nos instrumentos os determinantes sociais da saúde, que são fundamentais para explicar as desigualdades e as desigualdades. Do mesmo modo, a concepção de instrumentos genéricos é uma necessidade internacional de avaliar determinantes estruturais e intermediários.

[Forensic medical characteristics of the rate and structure of sudden death due to cardiovascular diseases in young residents of the Tula region]. / Sudebno-meditsinskaya kharakteristika rasprostranennosti i struktury vnezapnoi smerti ot serdechno-sosudistykh zabolevanii sredi lits molodogo vozrasta v Tul'skoi oblasti.

The objective is to study the prevalence and rate of sudden death from cardiovascular diseases (CVD) in the structure of non-violent death in people under 35 in the Tula region as a representative of a small region of the Russian Federation. A comparison with the data of the Federal State Statistics Service was made. The overall trend was determined. A non-parametric analysis of the initial data, clustering and visualization were performed based on the following parameters of the initial sample: «mortality rate from cardiovascular diseases (CVD) in the structure of non-violent death,¼ «morbidity,¼ and «number of doctors in the region.¼ The correlation of mortality from CVD according to Form 42 and the specified indicators of the medical and social status of the region was determined. The relationship between the rate of CVD-related sudden death and specified medical and social indicators was established.

A meta-analysis of agricultural conservation intentions, behaviors, and practices: Insights from 35 years of quantitative literature in the United States.

Conservation practices (CPs) are integral to maintaining the long-term viability of agro-ecological systems. Because farming systems and farmers' values and attitudes are heterogeneous, factors that consistently predict conservation behaviors remain elusive. Moreover, heterogeneity is present among studies regarding the type of CPs examined, and whether behavioral intentions or actual behaviors were measured. This study considers the characteristics of each CP, and whether a given study measured behavioral intention or actual behavior, to better understand farmers' adoption of CPs. We reviewed and analyzed 35 years (1982-2017) of quantitative conservation adoption literature in the United States. We categorized CPs based on their primary purpose, the type of benefit they provide, and whether they are operational or structural. We also examined the following five CPs: conservation tillage, buffers or borders, soil testing, grassed waterways, and cover crops. In our behavioral intention and actual behavior analysis, we found that attitudinal factors predicted both conservation intention and action (actual behavior), whereas current or previous use of practices only influenced actions, not stated conservation intentions. In our analysis focusing on CP characteristics, we found that having specific knowledge about and positive attitudes toward the CP, adoption of other CPs, seeking and using information, larger farm size, and vulnerable land predicted actual adoption across nearly all CP categorizations. Nuances emerge when comparing predictors of CPs that share a particular characteristic. For example, we found farm characteristics to be comparatively more important in predicting adoption of soil management CPs than nutrient and livestock management CPs, and farmers' stewardship identity to be more important for permanent practices than operational practices.

Integrated assessment of drought vulnerability for water resources management of Bina basin in Central India.

Drought is an extreme event and its frequency is expected to increase in future under the imminent threats of climate change. The areas vulnerable to drought are increasing due to increase in the spatial extent and severity of droughts. This necessitates the need for development of an integrated framework for assessment of drought vulnerability, which will be vital for water resources management policies focused towards such vulnerable areas. An integrated drought vulnerability assessment framework has been developed considering the physical indicators that vary spatially, social indicators that vary spatially but their temporal variation may be at longer time-frames, and spatio-temporal drought indicators that vary spatially and temporally during various months during drought years. This framework has been tested for Bina basin located in the drought prone Bundelkhand region of Madhya Pradesh. The drought indicators used in the study include (i) Standardized Precipitation Index (SPI) for evaluating meteorological drought characteristics, (ii) Surface water Drought Index (SDI) for evaluating streamflow drought characteristics, and (iii) Groundwater Drought Index (GDI) for evaluating groundwater drought characteristics. Groundwater levels are being observed at quarterly (3 monthly) time step only. So the relationships between GDI and 3-m SPI, 6-m SPI, and 12-m SPI have been investigated. Based on the best correlation, the 12-m SPI can be used to represent the groundwater drought in Bina basin and has therefore been used to assess the monthly variability in the groundwater drought characteristics. The spatially varying physical indicators including basin reach (elevation band), land use pattern and soil type; the spatio-temporal drought indicators including soil moisture drought, surface water drought and groundwater drought, rainfall departure and number of consecutive dry days; and the spatially varying social indicators including infants and young children, illiterate population, marginal workers and rural population have been used for the development of a Drought Vulnerability Index (DVI). The integrated drought vulnerability assessment framework has been conceptualized on the basis of DVI. Four vulnerability classes have been defined and the study area falls in mild to moderate vulnerable class, based on the analysis carried out for the various drought years in the basin. Appropriate drought management plans and mitigation strategies need to be developed to target these vulnerable areas in Bina basin.

[Forensic medical characteristics of the prevalence of sudden death from cardiovascular diseases in the constituent entities of the Russian Federation]. / Sudebno-meditsinskaya kharakteristika rasprostranennosti vnezapnoi smerti ot serdechno-sosudistykh zabolevanii v sub"ektakh Rossiiskoi Federatsii.

The purpose of the study is to study the prevalence and frequency of sudden death (SD) from cardiovascular diseases (CVD) in the structure of non-violent death, taking into account the socio-economic development of the constituent entities of the Russian Federation. We analyzed the frequency of this indicator, compared it with the data of the Federal State Statistics Service, and determined the overall dynamics. We conducted a non-parametric analysis of the initial data, carried out clustering and visualization based on the following parameters of the initial sample: «CVD mortality in the structure of non-violent death¼, «morbidity¼ and «per capita income level¼. Correlation dependences of the level of mortality from CVD according to the form 42 on the indicated indicators of the socio-economic condition of the subject were determined. Identified subjects of the Russian Federation with an increase in mortality from CVD; established the dependence of the level of VS on CVD and a number of medical and economic indicators.

Neighborhood characteristics of low radon testing activities: A longitudinal study in Atlanta, Georgia, United States.

Radon testing remains low even nationwide although its exposure is the leading cause of lung cancer among non-smokers. Little has been done to examine the neighborhood characteristics with low testing prevalence. This study investigated the associations between indoor radon testing and neighborhood characteristics in an urban environment with the highest Radon potential. A total of 25 years (1990-2015) of radon tests (n = 6355) were pooled from public and private sources in DeKalb County, Georgia, United States. Neighborhoods were characterized using racial residential segregation for African Amercians in addition to other social indicators. The associations between neighborhood characteristics and radon testing rates were evaluated using Ordinary Least Squares and Spatial Regression Models, respectively. Results show that the testing rates were lower than 6.5% over the 25 years. Summers followed by early springs experienced more tests than the other seasons. Areas of low testing rates (≤1.55%) spatially matches the mostly segregated neighborhoods. Residential segregation expanded in the 25 years and was significantly correlated (P value < 0.05) with low testing rates, even after other social indicators were controlled. Associations with the other social indicators, such as income or education, were weaker. Concertedly identifying the culturally relevant interventions in segregated communities is necessary to reduce and eliminate threats from environmental radon.

Perfil demográfico y epidemiológico de los casos de dengue en un municipio de Brasil / Demographic and Epidemiological Profile of Dengue Cases in a Municipality from Brazil

Introducción: Las epidemias de dengue imponen una carga importante a los servicios de salud, además de la pérdida económica ocasionada por bajas temporales del trabajo o por años de vidas perdidas como consecuencia de la muerte, lo que interfiere en el desempeño de las economías de los países. Objetivo: Analizar el perfil demográfico, social y epidemiológico de los casos de dengue en la población de Contagem-MG, además de evaluar los factores climáticos con el fin de brindar herramientas para la planificación de estrategias de salud pública. Método: Se realizó un estudio ecológico, a partir de una serie de tiempo, entre los años 2013 a 2017, en el municipio de Contagem-MG en Brasil. Resultados: Los grupos más afectados fueron las mujeres, adultos, mestizos, individuos con pocos años de estudio y los que vivían en regiones periféricas. Más del 99 por ciento de las personas tenía dengue sin signos de alarma. Las lluvias no parecen haber sido determinantes para el aumento del número de casos, dado que hubo lluvias en todos los años. Conclusiones: Para mejorar la lucha contra las epidemias estacionales de dengue, se sugiere el enfoque de planificación estratégica, con la elección y definición de metodologías para planificar una estrategia intersectorial en la solución de situaciones recurrentes. Así se puede incrementar la eficiencia de las políticas públicas y, por ende, las posibilidades de una gestión pública exitosa en la reducción de inequidades(AU)

Introduction: Dengue epidemics impose a significant burden on health services, in addition to the economic loss caused by temporary leaves from work or deaths, which interferes in the economic performance of countries. Objective: To analyze the demographic, social and epidemiological profile of dengue cases in the population of Contagem-MG; and to evaluate climatic factors in order to provide tools for planning public health strategies. Methods: An ecological study was conducted from a time series between 2013 and 2017 in Contagem-MG municipality from Brazil. Results: The most affected groups were women, adults, mestizos, people with few years of schooling, and those living in peripheral regions. More than 99 percent of the people suffered from dengue without warning signs. Rain does not seem to be a determinant factor in the increase on the number of cases, since it rained every year. Conclusions: To better fight against dengue seasonal epidemics, the strategic planning approach is suggested, with the selection and definition of methodologies for planning an intersectoral strategy to solve recurrent events. This could increase the efficiency of public policies and, therefore, the possibility of successful public management in the reduction of inequities(AU)

Stakeholder participation, indicators, assessment, and decision-making: applying adaptive management at the watershed scale.

Climate change, population growth, and declining federal budgets are threatening the health of ecosystems, and the services they provide. Under these changing conditions, managing landscapes and resources assumes new and unprecedented challenges. Adaptive management has been identified as a natural resource management approach that allows practitioners to incorporate change and uncertainty into decision-making through an iterative process that involves long-term monitoring and continued review and adjustment of management actions. However, the success of these efforts in watershed health relies on the collective and sustained monitoring of indicators, which is seldom studied. The purpose of this analysis is to examine (1) the practical challenge of choosing a list of indicators for long-term monitoring, (2) the negotiation process among stakeholders around the selection and interpretation of indicators, and (3) the communication tools that can be used to convey the assessment's results and findings. To do this, we analyze our ongoing work in the Cienega Watershed in southern Arizona. Our analysis shows that the selective use of indicators, regular assessment and review, and establishment of partnerships among stakeholders are all important elements in establishing effective adaptive management efforts. The selection of indicators and data sources is a moving target that requires regular consensus and review among stakeholders. The assessment itself is also a powerful engagement tool with the public at large, providing legitimacy and support to land management decision-making. Here, we outline some lessons learned that can be transferred to other cases and identify potential barriers for engagement, decision-making, and project success.

Influência de indicadores sociais na incidência e mortalidade da COVID-19 no Brasil em junho de 2020 / Influence of social indicators on the occurrence and mortality of COVID-19 in Brazil in june 2020

O estudo tem por objetivo analisar a influência de indicadores sociais das regiões e verificar sua correlação com a incidência e mortalidade causada pela COVID-19 no Brasil no período de junho de 2020. Trata-se de um estudo observacional, ecológico e analítico na qual foram incluídas nas análises todas Unidades Federativas brasileiras de 10/06/2020 à 13/06/2020. Considerou-se como variáveis relacionadas à COVID-19: taxa de incidência e mortalidade acumulada por 100 mil habitantes e taxa de letalidade acumulada. Como variáveis independentes, determinou-se: índice de desenvolvimento humano, percentual de pobreza e renda per capita. Verificou-se que regiões mais pobres (Norte e Nordeste) possuem maior incidência, mortalidade e letalidade por COVID-19 se comparado com as regiões mais ricas do (Sudeste, Sul e Centro-oeste). Esses resultados demonstram que os indicadores sociais possuem influência nas taxas de incidência e óbitos por 100 mil habitantes devido a COVID-19, além de apresentar correlações significativas entre si. Os achados do estudo podem ser usados para embasar e dar direcionamento a ações de combate ao COVID-19 no país, levando à criação de políticas públicas bem estruturadas e garantindo eficácia para o enfrentamento da doença em áreas com vulnerabilidade.

Current paper analyzes the influence of social indicators in Brazilian regions and verifies their correlation with the occurrence and mortality caused by COVID-19 in Brazil. All the Brazilian Federative States were included in current observational, ecological and analytical study from 06/10/2020 to 06/13/2020. Variables were related to COVID-19´s occurrence rate, lethality and accumulated mortality per 100,000 inhabitants. Independent variables comprised human development index, poverty percentage and per capita income. Results show that poorer regions have higher incidence, mortality and lethality by COVID-19 when compared to richer ones. These results demonstrate that social indicators influence the incidence and death rates per 100,000 inhabitants due to COVID-19, in addition to showing significant correlations with each other. The study findings may be used to support and guide actions to combat COVID-19 in the country.

Lifetime ostracism experiences and mechanisms of pain.

One social mechanism by which marginalization is enacted is via ostracism. Recent research has demonstrated ostracism's impact on physical health, but little is known about the relationship between accumulated lifetime experiences of ostracism and pain. Despite recent calls for added attention to social modulation of pain and social indicators of pain disparities, the impact of specific social factors on pain-including those of ostracism-are not well understood. Results of laboratory studies on the effects of acute ostracism experiences on pain sensitivity have been mixed. However, these studies have not considered lived and repeated experiences of ostracism, and primarily included single static measures of pain sensitivity. Additionally, inclusion and representation of the relationship between ostracism experiences and pain among people with minoritized identities are lacking in the current literature. In this study, we explored accumulated lifetime experiences of ostracism as a potential contributing factor to enhanced pain and one social mechanism by which societal inequity may create and maintain inequity in pain. We extracted measures of lifetime experiences of ostracism from six studies focused on social factors and (non-chronic) pain conducted between 2016 and 2020 (n = 505 adults). To retain and examine diversity within the sample, we used moderation and within-group analyses. Results indicate that greater experiences of lifetime ostracism are associated with lower cold pain tolerance, but not other pain measures, in the whole sample. Moderation and within-group analyses reveal opposing patterns of results between populations included in the extant literature (White participants, convenience samples) and those under-represented in the scientific literature (racialized groups, community samples). This study provides an example of a diversity science approach to examining social indicators of pain, illustrates the limited generalizability of previous studies on ostracism and pain, and highlights the need for increased representation and inclusion to understand mechanisms of pain and inequity.

Spatial dynamics of fetal mortality and the relationship with social vulnerability.

OBJECTIVES: To analyze the spatial-temporal patterns of fetal mortality according to its relationship with social vulnerability, identifying priority areas for intervention. METHODS: Ecological study conducted in the state of Pernambuco, Northeast region of Brazil, from 2011 to 2018. The mean fetal mortality rate per city was calculated for the studied period. A cluster analysis was performed to select cities with homogeneous characteristics regarding fetal mortality and social vulnerability, then the Attribute Weighting Algorithm and Pearson correlation techniques were employed. In the spatial analysis it was used the local empirical Bayesian modeling and global and local Moran statistics. RESULTS: Twelve thousand nine hundred and twelve thousand fetal deaths were registered. The fetal mortality rate for the period was 11.44 fetal deaths per 1,000 births. The number of groups formed was 7, in which correlation was identified between fetal mortality and dimensions, highlighting the correlations between fetal mortality rate and the Index of Social Vulnerability urban infrastructure for the municipalities in group 1 and 5, the values of the correlations found were 0.478 and 0.674 respectively. The spatial analysis identified areas of higher risk for fetal mortality distributed in regions of medium, high and very high social vulnerability. CONCLUSIONS: The study allowed observing the existing correlations between fetal mortality and social vulnerability and identifying priority areas for intervention, with a view to reducing fetal mortality in the state.

Indicadores de boas práticas em saúde para a população de rua: revisão de escopo / Indicadores de buenas prácticas en salud para los habitantes de la calle: revisión de alcance / Indicators of good health practices for the homeless population: a scoping review

Resumo Objetivo Identificar os indicadores utilizados para embasar as Boas Práticas em Saúde à população de rua. Métodos Trata-se de uma revisão de escopo cuja seleção dos artigos ocorreu em dezembro de 2019 e foi atualizada em agosto de 2020. Os termos utilizados para a busca foram: homeless persons, homeless, runway, foster care, street people, health status indicators, primary care nursing e primary health care. Foram incluídos estudos publicados em língua inglesa, espanhola e portuguesa, sem delimitação de tempo de publicação. Resultados Foram selecionados 29 artigos. A partir da leitura na íntegra, houve a emergência de quatro categorias empíricas de indicadores: Relação do usuário com o serviço de atendimento; Avaliação das condições de saúde e doença; Avaliação da inclusão social e Avaliação das mudanças nas características comportamentais e psicológicas. Os estudos encontrados utilizaram-se de indicadores majoritariamente para perceber a adesão ao propósito do projeto de intervenção tendo por alvo a população de rua. Conclusão A forma para verificação destes indicadores foi variada, assim como os projetos de intervenção, não há um consenso acerca de que tipo de indicadores seria fértil para a avaliação das ações realizadas.

Resumen Objetivo Identificar los indicadores utilizados para basar las Buenas Prácticas en Salud de los habitantes de la calle. Métodos Se trata de una revisión de alcance, cuya selección de artículos se realizó en diciembre de 2019 y fue actualizada en agosto de 2020. Los términos utilizados para la búsqueda fueron: homeless persons, homeless, runway, foster care, street people, health status indicators, primary care nursing y primary health care. Se incluyeron estudios publicados en idioma inglés, español y portugués, sin restricción del tiempo de publicación. Resultados Se seleccionaron 29 artículos. A partir de su lectura completa, surgieron cuatro categorías empíricas de indicadores: Relación del usuario con el servicio de atención, Evaluación de las condiciones de salud y enfermedad; Evaluación de la inclusión social y Evaluación de los cambios de características de comportamiento y psicológicas. Los estudios encontrados utilizaron mayormente indicadores para percibir la adherencia al propósito del proyecto de intervención que tiene como destinatarios a los habitantes de la calle. Conclusión La forma de verificación de estos indicadores fue variada, así como los proyectos de intervención. No existe consenso sobre qué tipo de indicadores sería provechoso para la evaluación de las acciones realizadas.

Abstract Objective To identify the indicators used to support good health practices for the homeless population. Methods This is a scoping review whose selection of articles took place in December 2019 and was updated in August 2020. The terms used for the search were: homeless persons, homeless, runway, foster care, street people, health status indicators, primary nursing care and primary health care. Studies published in English, Spanish and Portuguese were included, without limitation of publication time. Results A total of 29 articles were selected. From the reading in full, four empirical categories of indicators emerged: User relationship with service; Assessment of health conditions and disease; Assessment of social inclusion; and Assessment of changes in behavioral and psychological characteristics. The studies found used indicators mostly to perceive compliance with the purpose of the intervention project targeting the homeless population. Conclusion The way to verify these indicators was varied, as well as the intervention projects, there is no consensus about what type of indicators would be fertile for assessment of the actions carried out.