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Cien Saude Colet ; 25(9): 3385-3392, 2020 Sep.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32876242


In the current scenario of the COVID-19 pandemic, Brazilian states and municipalities have adopted social distancing measures as a strategy to reduce the number of cases and control the disease. These measures affect populations and territories differently. This study aims to analyze the trend of social distancing in this pandemic and its relationship with the context of living conditions in Salvador, Bahia, Brazil. An ecological study with spatial distribution was conducted. The municipality's Social Distancing Index and the Living Conditions Index were calculated. Global and Local Moran Indices were employed to assess the degree of spatial dependence and autocorrelation. Fluctuations were observed in the social distancing levels during the analyzed period, with higher distancing percentages in neighborhoods with more favorable living conditions. The analysis and interpretation of COVID-19 containment measures, such as social distancing, should consider the profile of local vulnerability of each territory for the correct dimensioning of pandemic mitigation strategies from the perspective of developing social actions enabling greater adherence of the most impoverished populations.

Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Condições Sociais , Isolamento Social , Brasil/epidemiologia , Cidades , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Análise Espacial , Populações Vulneráveis
Infect Dis Poverty ; 9(1): 124, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32867851


BACKGROUND: Coronavirus disease 2019 (COVID-19) was confirmed in Brazil in February 2020. Since then, the disease has spread throughout the country, reaching the poorest areas. This study analyzes the relationship between COVID-19 and the population's living conditions. We aimed to identify social determinants related to the incidence, mortality, and case fatality rate of COVID-19 in Brazil, in 2020. METHODS: This is an ecological study evaluating the relationship between COVID-19 incidence, mortality, and case fatality rates and 49 social indicators of human development and social vulnerability. For the analysis, bivariate spatial correlation and multivariate and spatial regression models (spatial lag model and spatial error models) were used, considering a 95% confidence interval and a significance level of 5%. RESULTS: A total of 44.8% of municipalities registered confirmed cases of COVID-19 and 14.7% had deaths. We observed that 56.2% of municipalities with confirmed cases had very low human development (COVID-19 incidence rate: 59.00/100 000; mortality rate: 36.75/1 000 000), and 52.8% had very high vulnerability (COVID-19 incidence rate: 41.68/100 000; mortality rate: 27.46/1 000 000). The regression model showed 17 indicators associated with transmission of COVID-19 in Brazil. CONCLUSIONS: Although COVID-19 first arrived in the most developed and least vulnerable municipalities in Brazil, it has already reached locations that are farther from large urban centers, whose populations are exposed to a context of intense social vulnerability. Based on these findings, it is necessary to adopt measures that take local social aspects into account in order to contain the pandemic.

Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Determinantes Sociais da Saúde , Adolescente , Brasil/epidemiologia , Criança , Pré-Escolar , Intervalos de Confiança , Infecções por Coronavirus/mortalidade , Educação , Emprego , Humanos , Incidência , Renda , Longevidade , Análise Multivariada , Pandemias , Pneumonia Viral/mortalidade , Pobreza , Análise de Regressão , Saneamento , Esgotos , Condições Sociais , Análise Espacial , Abastecimento de Água/normas , Adulto Jovem
Rev Lat Am Enfermagem ; 28: e3343, 2020.
Artigo em Português, Espanhol, Inglês | MEDLINE | ID: mdl-32876291


OBJECTIVE: to analyze the association between the occurrence of new tuberculosis cases and the Adapted Living Condition Index, and to describe the spatial distribution in an endemic municipality. METHOD: this is an analytical and ecological study that was developed from new cases in residents of an endemic municipality in the North Region of Brazil. The data were obtained from the Notifiable Diseases Information System and from the 2010 Demographic Census. The Adapted Living Conditions Index was obtained by factor analysis and its association with the occurrence of the disease was analyzed by means of the chi-square test. The type I error was set at 0.05. Kernel estimation was used to describe the density of tuberculosis in each census sector. RESULTS: the incidence coefficient was 97.5/100,000 inhabitants. The data showed a statistically significant association between the number of cases and socioeconomic class, with the fact that belonging to the highest economic class reduces the chance of the disease occurring. The thematic maps showed that tuberculosis was distributed in a heterogeneous way with a concentration in the Southern region of the municipality. CONCLUSION: tuberculosis, associated with precarious living conditions, reinforces the importance of discussion on social determinants in the health-disease process to subsidize equitable health actions in risk areas, upon a context of vulnerability.

Condições Sociais , Tuberculose/epidemiologia , Brasil/epidemiologia , Cidades , Humanos , Fatores Socioeconômicos
Rev Panam Salud Publica ; 44, sept. 2020
Artigo em Inglês | PAHO-IRIS | ID: phr-52265


[ABSTRACT]. Objective. To identify socioeconomic factors associated with antimicrobial resistance of Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli in Chilean hospitals (2008–2017). Methods. We reviewed the scientific literature on socioeconomic factors associated with the emergence and dissemination of antimicrobial resistance. Using multivariate regression, we tested findings from the literature drawing from a longitudinal dataset on antimicrobial resistance from 41 major private and public hospitals and a nationally representative household survey in Chile (2008–2017). We estimated resistance rates for three priority antibiotic–bacterium pairs, as defined by the Organisation for Economic Co-operation and Development; i.e., imipenem and meropenem resistant P. aeruginosa, cloxacillin resistant S. aureus, and cefotaxime and ciprofloxacin resistant E. coli. Results. Evidence from the literature review suggests poverty and material deprivation are important risk factors for the emergence and transmission of antimicrobial resistance. Most studies found that worse socioeconomic indicators were associated with higher rates of antimicrobial resistance. Our analysis showed an overall antimicrobial resistance rate of 32.5%, with the highest rates for S. aureus (40.6%) and the lowest for E. coli (25.7%). We found a small but consistent negative association between socioeconomic factors (income, education, and occupation) and overall antimicrobial resistance in univariate (p < 0.01) and multivariate analyses (p < 0.01), driven by resistant P. aeruginosa and S. aureus. Conclusion. Socioeconomic factors beyond health care and hospital settings may affect the emergence and dissemination of antimicrobial resistance. Preventing and controlling antimicrobial resistance requires efforts above and beyond reducing antibiotic consumption.

[RESUMEN]. Objetivo. Determinar los factores socioeconómicos relacionados con la resistencia a los antimicrobianos de Pseudomona aeruginosa, Staphylococcus aureus y Escherichia coli en hospitales chilenos (2008-2017). Métodos. Se revisó la bibliografía científica acerca de los factores socioeconómicos relacionados con la aparición y el incremento de la resistencia a los antimicrobianos. Mediante una regresión con múltiples variables se examinaron los resultados de la bibliografía respecto a un conjunto de datos longitudinales sobre resistencia a los antimicrobianos de 41 importantes hospitales privados y públicos, así como a una encuesta domiciliaria representativa a nivel nacional en Chile (2008-2017). Se estimaron las tasas de resistencia para tres pares de antibióticos y bacterias prioritarios, de conformidad con lo definido por la Organización de Cooperación y Desarrollo Económicos, es decir: P. aeruginosa, resistente a imipenem y meropenem; S. aureus, resistente a cloxacilina y E. coli, resistente a la cefotaxima y ciprofloxacino. Resultados. La evidencia de la revisión bibliográfica es indicativa de que la pobreza y la privación material suponen importantes factores de riesgo para la aparición y transmisión de la resistencia a los antimicrobianos. La mayoría de los estudios ha demostrado que los peores indicadores socioeconómicos están asociados a mayores tasas de resistencia a los antimicrobianos. Este análisis ha indicado una tasa general de resistencia a los antimicrobianos de 32,5 %, con las tasas más elevadas para S. aureus (40,6 %) y las más bajas para E. coli (25,7 %). Se apreció una asociación negativa mínima, aunque uniforme, entre los factores socioeconómicos (ingresos, educación y ocupación) y la resistencia general a los antimicrobianos en un análisis de variable única (p < 0,01) y análisis multifactoriales (p < 0,01), impulsadas por las bacterias P. aeruginosa y S. aureus resistentes. Conclusiones. Los factores socioeconómicos no relacionados con la atención de la salud y los entornos hospitalarios pueden afectar la aparición y la propagación de la resistencia a los antimicrobianos. Su prevención y control precisan esfuerzos adicionales que se sumen a la reducción del consumo de antibióticos.

[RESUMO]. Objetivo. Identificar os fatores socioeconômicos associados à resistência antimicrobiana de Pseudomonas aeruginosa, Staphylococcus aureus e Escherichia coli em hospitais chilenos (2008-2017). Métodos. Fizemos uma revisão da literatura científica sobre os fatores socioeconômicos associados ao surgimento e à disseminação da resistência antimicrobiana. Usando a regressão multivariada, testamos os resultados da literatura baseando-nos em um conjunto de dados longitudinais sobre a resistência antimicrobiana em 41 grandes hospitais privados e públicos e em uma pesquisa domiciliar representativa da realidade nacional no Chile (2008-2017). Estimamos as taxas de resistência em três pares prioritários de bactérias e antibióticos, como definido pela Organização para a Cooperação e o Desenvolvimento Econômico: P. aeruginosa resistente a imipenem e meropenem, S. aureus resistente a cloxacilina e E. coli resistente a cefotaxima e ciprofloxacino. Resultados. As evidências desta revisão da literatura sugerem que a pobreza e a privação material são fatores de risco importantes para o surgimento e a transmissão da resistência antimicrobiana. A maior parte dos estudos constatou que piores indicadores socioeconômicos estão associados a taxas mais altas de resistência antimicrobiana. A nossa análise mostrou uma taxa global de resistência antimicrobiana de 32,5%; S. aureus apresentou as taxas mais altas (40,6%) e E. coli as mais baixas (25,7%). As análises univariadas (p<0,01) e multivariadas (p<0,01) identificaram uma associação negativa pequena, porém consistente, entre fatores socioeconômicos (renda, educação e ocupação) e a resistência antimicrobiana global em P. aeruginosa e S. aureus. Conclusão. Fatores socioeconômicos, para além dos cuidados de saúde e dos ambientes hospitalares, podem afetar o surgimento e a disseminação da resistência antimicrobiana. Para prevenir e controlar esta resistência, é preciso fazer esforços que não se limitem à redução do consumo de antibióticos.

Resistência Microbiana a Medicamentos , Antibacterianos , Condições Sociais , Determinantes Sociais da Saúde , América Latina , Resistência Microbiana a Medicamentos , Antibacterianos , Condições Sociais , Determinantes Sociais da Saúde , América Latina , Resistência Microbiana a Medicamentos , Condições Sociais , Determinantes Sociais da Saúde
Revista Digital de Postgrado ; 9(2): 216, ago. 2020.
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1103452


Los primeros mil días de vida, desde la concepción hasta el final de los primeros dos años de vida, constituye un período crucial para establecer el desarrollo de la enfermedad o de la salud en la vida futura de los individuos. La exposición a ambientes adversos determinará las alteraciones temporales en el ADN que perduran en el tiempo que dicha exposición exista. Las políticas y programas destinados a garantizar el bienestar durante esta ventana crítica del crecimiento son cruciales para que la población goce de las mejores condiciones posibles que permitan la expresión de su máximo potencial, al cual están programados para desarrollar. Palabras clave: condiciones ambientales, programas y políticas(AU)

The first thousand days of life, from the conception until the end of the first two years of life, constitutes a key period in which the development of disease or health establishes in the future lives of individuals. Exposure to adverse environments will determine the temporary impairments in DNA that last as long as the exposure exists. Policies and programs aimed at guaranteeing well-being during this critical window of growth are crucial for the population to enjoy the best possible conditions that allow the expression of their maximum potential, to which they are programmed to develop(AU)

Humanos , Recém-Nascido , Lactente , Condições Sociais , Programas de Nutrição , Transtornos da Nutrição do Lactente , Crescimento e Desenvolvimento , Pobreza , Desnutrição , Nutrição Pré-Natal
Environ Sci Pollut Res Int ; 27(27): 34567-34573, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32648218


The study critically reviewed Pakistan's provincial updates of coronavirus disease 2019 (COVID-19) and discussed the current challenges faced by the government in a given context. The coronavirus-associated death tolls have been increasing rapidly in a country. The provincial status of confirmed cases of coronavirus is higher in Punjab, followed by the Sindh, Khyber Pakhtunkhwa (KPK), and Balochistan. The case fatality ratio shows that KPK has a higher ratio, i.e., 5.11%, followed by the Punjab, i.e., 1.82%; Sindh, i.e., 1.80%; Balochistan, i.e., 1.28%; Gilgit-Baltistan, i.e., 0.71%; and Federal territory, i.e., 0.66%. The country has a less testing capacity to identify more suspected coronavirus patients. The study calculated that if we increase five times our testing capacity from the current date, the total registered cases will be reached to 137,370 and death tolls will increase up to 3090. It is highly needed to increase testing capacity across Pakistan in order to minimize the outbreak of coronavirus. The provincial government should follow the Federal Government instructions to contain coronavirus by increasing testing capacities, tracing suspected patients, smart lockdowns, emergency relief to the poor, and vigilant monitoring system.

Infecções por Coronavirus , Coronavirus , Pandemias , Pneumonia Viral , Condições Sociais , Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Governo , Humanos , Paquistão
Artigo em Inglês | MEDLINE | ID: mdl-32660047


A positive future orientation (FO) is associated with a range of positive outcomes. It is a crucial resilience factor that assists individuals to navigate developmental difficulties during the transition to young adulthood and during periods of social adversity. Exposure to negative social context threatens young people's FO. The social demonstrations and the outbreak of coronavirus disease in Hong Kong over the past year have caused considerable hardship to the local society. Under such circumstance, young people in Hong Kong may develop a negative FO. Scant research has directly examined the relationship between perceived social hardship and FO as well as the underlying mechanism among Hong Kong young people. In this study, we tested the idea that young people's perceived social hardship would be negatively related to FO via belief in a just world, a well-known foundation for individuals to think, feel, and plan their future. Participants were 554 students recruited from eight universities in Hong Kong. They filled in self-report questionnaires online. Results of structural equation modeling supported our hypothesis. These findings shed light on how to nurture Hong Kong young people to develop a positive mindset during periods of social hardship.

Condições Sociais , Estudantes/psicologia , Previsões , Hong Kong , Humanos , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Universidades , Adulto Jovem
Proc Natl Acad Sci U S A ; 117(31): 18378-18384, 2020 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-32690675


We often talk about peace as if the concept is self-explanatory. Yet people can have various theories about what peace "is." In this study, we examine the lay theories of peace of citizens embroiled in a prolonged ethnonational conflict. We show that lay theories of peace 1) depend on whether one belongs to the high-power or low-power party and 2) explain citizens' fundamental approaches to conflict resolution. Specifically, we explore the link between power asymmetry, lay theories of peace, and preference for conflict resolution strategies within large-scale samples of Palestinian residents of the West Bank and the Gaza Strip and Jewish residents of Israel. Results reveal that members of the high-power group (in this case Jewish-Israelis) are more likely to associate peace with harmonious relationships (termed "positive peace") than with the attainment of justice (termed "structural peace"), while members of the low-power group (in this case Palestinians) exhibit an opposite pattern. Yet both groups firmly and equally interpret peace as the termination of war and bloodshed (termed "negative peace"). Importantly, across societies, associating peace with negative peace more than with positive or structural peace predicts citizens' desire for a solution that entails the partition of land (the Two-State Solution) whereas associating peace with structural or positive peace more than with negative peace predicts citizens' desire to solve the conflict by sharing the land (the One-State Solution). This study demonstrates the theoretical and policy-relevant utility of studying how those most affected by war understand the concept of peace.

Políticas de Controle Social , Violência/legislação & jurisprudência , Violência/psicologia , Agressão/psicologia , Árabes/legislação & jurisprudência , Árabes/psicologia , Humanos , Israel , Judeus/legislação & jurisprudência , Judeus/psicologia , Oriente Médio , Condições Sociais , Violência/etnologia
Rev. Saúde Pública Paraná (Online) ; 3(1): 75-85, 08/07/2020.
Artigo em Português | Coleciona SUS, CONASS, SESA-PR | ID: biblio-1119369


Apesar da diminuição dos óbitos infantis, ainda se observa a necessidade de continuidade de redução, sobretudo da mortalidade perinatal, que se encontra distante dos resultados dos países desenvolvidos os quais abrangem um dígito. Objetivo: investigar a correlação espacial entre a mortalidade perinatal e os indicadores sociais, econômicos e demográficos dos municípios do Paraná. Método: estudo epidemiológico, tipo ecológico, com dados secundários. Utilizadas as variáveis de mortalidade, sociais, econômicas e demográficas, analisadas pelo Índice de Moran e pelo Indicador Espacial de Associação Local. Resultados: identificou-se autocorrelação espacial direta entre mortalidade perinatal (0,638) com analfabetismo (0,183), fecundidade entre 15 a 17 anos (0,074) e Índice de Gini (0,143) e, ainda, autocorrelação negativa para taxa de atividade (-0,142), grau de urbanização (-0,111) e Índice de desenvolvimento Humano Municipal (-0,276). Conclusão: a análise espacial permitiu confirmar a relação entre a mortalidade perinatal e as condições sociais, econômicas e demográficas, bem como, a identificação das regiões que necessitam de investimentos sociais e em saúde devido a maior vulnerabilidade a este tipo de óbito. (AU)

Despite the decrease in infant deaths, there is still a need to reduce them, especially Perinatal Mortality, which is far from the results of developed countries, which are of one digit. Objective: to investigate a spatial correlation between Perinatal Mortality and social, economic and demographic indicators in the municipalities of the state of Paraná. Method: epidemiological, ecological study, with secondary data. Mortality, social, economic and demographic variables were used and analyzed through the Moran Index and the Local Association Spatial Indicator. Results: A direct spatial autocorrelation was identified between Perinatal Mortality (0.638) and Illiteracy (0.183), Fertility between 15 and 17 years (0.074) and Gini Index (0.143), and also negative autocorrelation for Activity Rate (-0.142), Level of Urbanization (-0.111), and Municipal Human Development Index (-0.276). Conclusion: The spatial analysis allowed the confirmation of a relationship between Perinatal Mortality and social, economic and demographic conditions, and the identification of regions that require social and health investments because they are more vulnerable to this type of death. (AU)

Humanos , Feminino , Gravidez , Recém-Nascido , Adolescente , Adulto , Condições Sociais , Saúde Materno-Infantil , Mortalidade Perinatal , Análise Espacial
PLoS One ; 15(6): e0234006, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497057


BACKGROUND: Immigrants from low- and middle-income countries who have settled in high-income countries show higher risks of depression in comparison with host populations. The risks are associated with adverse social conditions. Indecisive results have been reported on the depression risks of the offspring of immigrant populations. OBJECTIVE: To assess the prevalence of depressed mood in immigrant offspring relative to the host population and to analyse whether that risk is explained by social conditions. METHODS: Cross-sectional data from the Dutch HELIUS study were analysed, involving 19,904 men and women of Dutch, South-Asian Surinamese, African Surinamese, Turkish or Moroccan ethnic descent aged 18 to 70. Depressive symptomatology was assessed using the Patient Health Questionnaire-9 (PHQ-9). Indicators of social conditions were socioeconomic position (educational level, occupational level, employment status), perceived ethnic discrimination and sociocultural integration (ethnic identity, cultural orientation, social network). We used logistic regression to assess the risk of depressed mood (PHQ-9 sum score ≥10) in immigrants' offspring, as well as in first generation immigrants, relative to the risk in the host population. Social indicators were stepwise added to the model. RESULTS: The prevalence of depressed mood was 13% to 20% among immigrant offspring, with the lowest level for those of African Surinamese descent; prevalence in the Dutch origin population was 7%. Relative risk of depressed mood, expressed as average marginal effects (AMEs), decreased substantially in all offspring groups after adjustment for socioeconomic indicators and discrimination. E.g. the AME of Turkish vs. Dutch decreased from 0.11 (0.08-0.13) to 0.05 (0.03-0.08). Patterns resembled those in first generation immigrants. CONCLUSIONS: Results suggest that the observed higher prevalence of depressed mood in immigrants' offspring will decline to the level of the host population as the various populations grow closer in terms of socioeconomic position and as immigrant offspring cease to experience discrimination.

Depressão/epidemiologia , Emigrantes e Imigrantes , Adolescente , Adulto , Afeto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Prevalência , Fatores de Risco , Condições Sociais , Fatores Socioeconômicos , Adulto Jovem
Med Care ; 58(7): 586-593, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32520834


BACKGROUND: Social factors are important drivers of health. However, it is unclear to what extent neighborhood social conditions are associated with total and preventable health care utilization and costs. OBJECTIVES: To examine the association of neighborhood social conditions with total annual and potentially preventable Medicare costs. RESEARCH DESIGN AND SUBJECTS: Retrospective cohort study. Medicare claims data from 2013 to 2014 linked with neighborhood social conditions at the US census block group level of 2013 for 93,429 Medicare fee-for-service and dually eligible patients. MEASURES: Neighborhood social conditions were measured by Area Deprivation Index at the census block group level, categorized into quintiles. Outcomes included total annual and potentially preventable utilization and costs. RESULTS: After adjustment for demographics and comorbidities, patients with the least disadvantaged social conditions had higher total annual Medicare costs [$427; 95% confidence interval (CI), $200-$655] and similar potentially preventable costs (-$23; 95% CI, -$56 to $10) as compared with patients with the intermediate level social conditions. Patients with the most disadvantaged social conditions had similar total Medicare costs (-$22; 95% CI, -$342 to $298) but higher potentially preventable costs ($53; 95% CI, $1-$104) than patients with the intermediate level social conditions. CONCLUSIONS: Disadvantaged neighborhood conditions are associated with lower total annual Medicare costs but higher potentially preventable costs after controlling for demographic, medical, and other patient characteristics. Socioeconomic barriers may limit access and use of primary care and disease management services, resulting in a higher proportion of their health care costs going to potentially preventable care.

Custos de Cuidados de Saúde/normas , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Condições Sociais/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Correlação de Dados , Feminino , Custos de Cuidados de Saúde/estatística & dados numéricos , Humanos , Masculino , Medicare/organização & administração , Medicare/estatística & dados numéricos , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos , Estados Unidos
Rev Bras Epidemiol ; 23: e200038, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32491050


INTRODUCTION: Sexual violence has emerged in the health field with changes in the epidemiological profiles of populations. METHODOLOGY: An ecological study with 5,565 Brazilian municipalities between 2010 and 2014. A descriptive analysis of the variables (Population rate of sexual violence reporting, household income per capita and HDI) and their stratification by quintile was performed. In order to explore the factors associated with changes in social inequalities regarding the rate of reporting of sexual violence, the Slope Index of Inequality and Relative Index of Inequality were adopted. An Equiplot was constructed for the outcome on each independent variable. RESULTS: The mean rate of reports of sexual violence in Brazil was 4.38 reports/100,000 inhabitants for the period. There was an increase in the rate of sexual violence and improvement in socioeconomic conditions. There was a higher rate of reporting in the quintile with better living conditions. An increase in the inequality of the rate of sexual violence as a function of household income and the HDI was observed. Several factors seem to influence the increase of reports of sexual violence in the country, among them the improvement in the living conditions of the population and greater moral sensitivity to violence. However, there is still a disparity in reporting among municipalities according to their socioeconomic status. CONCLUSION: The lack of public policies on social equity in health has interfered with reports of sexual violence in the country and has widened health inequities.

Disparidades nos Níveis de Saúde , Delitos Sexuais/tendências , Determinantes Sociais da Saúde/tendências , Fatores Socioeconômicos , Brasil/epidemiologia , Cidades/epidemiologia , Feminino , Humanos , Modelos Lineares , Masculino , Notificação de Abuso , Delitos Sexuais/estatística & dados numéricos , Condições Sociais/tendências , Fatores de Tempo
J Epidemiol Community Health ; 74(9): 683-688, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32503892


BACKGROUND: Despite media claims that coronavirus disease 2019 (COVID-19) is uniting societies and countries in shared experience, there has been concern that the pandemic is in fact exposing and widening existing inequalities within societies. Data have shown these differences for cases and fatalities, but data on other types of adversities are lacking. Therefore, this study explored the changing patterns of adversity relating to the COVID-19 pandemic by socioeconomic position (SEP) during the early weeks of lockdown in the UK. METHODS: Data were from 12 527 UK adults in the University College London COVID-19 Social Study (a panel study that involves online weekly data collection from participants during the COVID-19 pandemic). We analysed data collected from 25 March to 14 April 2020. The sample was well-stratified and weighted to population proportions of gender, age, ethnicity, education and country of living. We used Poisson and logit models to assess 10 different types of adverse experiences depending on an index of SEP over time. RESULTS: There was a clear gradient across the number of adverse events experienced each week by SEP. This was most clearly seen for adversities relating to finances (including loss of employment and cut in income) and basic needs (including access to food and medications) but less for experiences directly relating to the virus. Inequalities were maintained with no reductions in discrepancies between socioeconomic groups over time. CONCLUSIONS: There were clear inequalities in adverse experiences during the COVID-19 pandemic in the early weeks of lockdown in the UK. Results suggest that measures taken to try to reduce such adverse events did not go far enough in tackling inequality.

Infecções por Coronavirus , Efeitos Psicossociais da Doença , Renda/estatística & dados numéricos , Pandemias/economia , Pneumonia Viral , Qualidade de Vida/psicologia , Quarentena/economia , Fatores Socioeconômicos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Recessão Econômica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Quarentena/psicologia , Perfil de Impacto da Doença , Condições Sociais , Reino Unido/epidemiologia , Adulto Jovem
J Med Internet Res ; 22(6): e19361, 2020 06 02.
Artigo em Inglês | MEDLINE | ID: covidwho-378294


Digital health innovations have been rapidly implemented and scaled to provide solutions to health delivery challenges posed by the coronavirus disease (COVID-19) pandemic. This has provided people with ongoing access to vital health services while minimizing their potential exposure to infection and allowing them to maintain social distancing. However, these solutions may have unintended consequences for health equity. Poverty, lack of access to digital health, poor engagement with digital health for some communities, and barriers to digital health literacy are some factors that can contribute to poor health outcomes. We present the Digital Health Equity Framework, which can be used to consider health equity factors. Along with person-centered care, digital health equity should be incorporated into health provider training and should be championed at the individual, institutional, and social levels. Important future directions will be to develop measurement-based approaches to digital health equity and to use these findings to further validate and refine this model.

Acesso à Informação , Infecções por Coronavirus , Equidade em Saúde , Disparidades em Assistência à Saúde , Pandemias , Pneumonia Viral , Condições Sociais , Betacoronavirus , Coronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia