Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis
São Paulo med. j
; 136(1): 51-58, Jan.-Feb. 2018. tab
Artículo
en Inglés
| LILACS
| ID: biblio-904137
Biblioteca responsable:
BR1.1
ABSTRACT
ABSTRACT BACKGROUND:
Information about multimorbidity is scarce in developing countries. This study aimed to estimate the association of educational attainment with occurrences of multimorbidity in a population of public employees on university campuses in Rio de Janeiro. DESIGN ANDSETTING:
We conducted cross-sectional analyses on baseline data (1999-2001) from 3,253 participants in the Pró-Saúde study, conducted in Brazil.METHODS:
The prevalence of multimorbidity, defined as a self-reported history of medical diagnoses of two or more chronic conditions, was estimated according to sex, age, smoking, obesity and educational level. The association between education and multimorbidity was estimated using odds ratios (OR) and the relative and slope indices of inequality, in order to quantify the degree of educational inequality among individuals with multimorbidity in this population.RESULTS:
Greater age, female sex, smoking and obesity had direct associations with multimorbidity; and tobacco exposure and obesity also showed direct relationships with poorer educational level. There was a monotonic inverse linear trend between educational level and the presence of multimorbidity among women, with twice the odds (OR 2.47; 95% confidence interval, CI 1.42-4.40) between extremities of schooling categories. There was excess multimorbidity of 22% at the lowest extremity of schooling, thus showing that women with worse educational status were more affected by the outcome. No trend and no excess multimorbidity was seen among men.CONCLUSIONS:
Educational inequality is an important determinant for development of multimorbidity. Men and women experience its effect differently. Researchers need to consider that sex may be an effect modifier in multimorbidity studies.
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Contexto en salud:
Agenda de Salud Sostenible para las Américas
/
ODS3 - Salud y Bienestar
Problema de salud:
Objetivo 1: Acceso equitativo a servicios de salud
/
Meta 3.8: Alcanzar cobertura universal de salud
Base de datos:
LILACS
Asunto principal:
Factores Socioeconómicos
/
Enfermedad Crónica
/
Escolaridad
/
Multimorbilidad
Tipo de estudio:
Estudio observacional
/
Estudio de prevalencia
/
Factores de riesgo
Aspecto:
Determinantes sociales de la salud
/
Equidad y inequidad
/
Preferencia del paciente
Límite:
Adulto
/
Anciano
/
Femenino
/
Humanos
/
Masculino
País/Región como asunto:
America del Sur
/
Brasil
Idioma:
Inglés
Revista:
São Paulo med. j
Asunto de la revista:
Cirurgia Geral
/
Cincia
/
Ginecologia
/
Medicina
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Año:
2018
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Secretaria Municipal de Saúde do Rio de Janeiro/BR