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Fatores associados à incidência e à piora do problema de coluna durante a primeira onda da COVID-19 no Brasil
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Romero, Dalia Elena

; Muzy, Jessica

; Maia, Leo Ramos

; Almeida, Wanessa da Silva de

; Silva, Danilo Rodrigues Pereira da

; Malta, Deborah Carvalho

; Souza Junior, Paulo Roberto Borges de

Ciência & Saúde Coletiva

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mar 2023, Volume 28 N. 3 Pages 771 - 784

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo O artigo tem como objetivo estimar a incidência e o agravamento do problema de coluna (PC) durante a primeira onda da COVID-19 no Brasil, bem como investigar os fatores demográficos, socioeconômicos e as mudanças nas condições de vida associadas. Utilizou-se a ConVid - Pesquisa de Comportamentos, realizada entre abril e maio de 2020, como fonte de dados. Estimou-se o número e a distribuição dos entrevistados que desenvolveram PC e a dos que tiveram agravamento no problema preexistente, seus intervalos de 95% de confiança e o teste qui-quadrado de Pearson. Estimou-se também a razão de chance de desenvolver PC ou ter piora de problema preexistente por meio de modelos de regressão logística múltipla. O PC preexistente foi reportado por 33,9% (IC95% 32,5-35,3) dos entrevistados e mais da metade (54,4%; IC95% 51,9-56,9) teve piora do quadro. A incidência cumulativa de PC na primeira onda da pandemia foi de 40,9% (IC95% 39,2-42,7). Ser mulher, o aumento percebido do trabalho doméstico e o sentimento frequente de tristeza ou depressão foram associados a ambos os desfechos. Os fatores socioeconômicos não foram associados a nenhum dos desfechos. A alta incidência e agravamento do PC durante a primeira onda revelam a necessidade de estudos em períodos mais recentes, dada a longa duração da pandemia.

Abstract The article aims to estimate the incidence and worsening of back pain (BP) during the first wave of COVID-19 in Brazil, as well as to investigate demographic, socioeconomic factors and associated changes in living conditions. ConVid - Behavior Research, applied between April and May 2020, was used as data source. The number and distribution of respondents who developed BP and those who had a worsening of the preexisting problem, their 95% confidence intervals and Pearson’s Chi-square test were estimated. The odds ratio of developing BP or worsening a preexisting problem was also estimated using multiple logistic regression models. Pre-existing BP was reported by 33.9% (95%CI 32.5-35.3) of respondents and more than half (54.4%; 95%CI 51.9-56.9) had worsened. The cumulative incidence of BP in the first wave of the pandemic was 40.9% (95%CI 39.2-42.7). Being a woman, the perceived increase in housework and the frequent feeling of sadness or depression were associated with both outcomes. Socioeconomic factors were not associated with any of outcome. The high incidence and worsening of BP during the first wave reveal the need for studies in more recent periods, given the long duration of the pandemic.

https://doi.org/10.1590/1413-81232023283.13042022

Fatores associados à incidência e à piora do problema de coluna durante a primeira onda da COVID-19 no Brasil
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Romero, Dalia Elena

; Muzy, Jessica

; Maia, Leo Ramos

; Almeida, Wanessa da Silva de

; Silva, Danilo Rodrigues Pereira da

; Malta, Deborah Carvalho

; Souza Junior, Paulo Roberto Borges de

Ciência & Saúde Coletiva

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mar 2023, Volume 28 N. 3 Pages 771 - 784

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232023283.13042022

Use of psychotropic drugs by population in an area affected by the tailings dam rupture: Brumadinho Health Project
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Loyola Filho, Antônio Ignácio de

; Firmo, Josélia Oliveira Araújo

; Mambrini, Juliana Vaz de Melo

; Peixoto, Sérgio Viana

; Souza Junior, Paulo Roberto Borges de

; Nascimento, Mariana Martins Gonzaga do

Revista Brasileira de Epidemiologia

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2022, Volume 25 Suppl. 2 elocation e220012

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT: Objective: To describe the consumption of psychotropic drugs in the adult population residing in Brumadinho, Minas Gerais, after the Vale dam collapse, which occurred in 2019. Methods: This is a cross-sectional study, part of the Brumadinho Health Project, developed in 2021, with a representative population-based sample of adults (18 years and over) residing in Brumadinho. A total of 2,805 adults with information on self-reported use of psychotropic drugs (antidepressants and anxiolytics-hypnotics/sedatives) in the last 15 days were included in the analysis. The prevalence of psychotropic drug use was estimated, and the most used psychotropic drugs were identified. Pearson’s chi-square test (with Rao-Scott correction) was used to test associations between exposures and use of psychotropic drugs, considering a significance level of p<0.05. Results: The use of antidepressants (14.2%) was more common than the use of anxiolytics or hypnotics/sedatives (5.2%), with sertraline and fluoxetine being the most used antidepressants. The use of anxiolytics and hypnotics/sedatives was higher among residents who lived in the area directly affected by the dam’s mud, and the use of any psychotropic drug was higher among those who lost a relative/friend in the disaster and assessed that their health worsened after the disaster, and among women. Conclusion: The results of the study corroborate what was observed in other populations exposed to similar tragedies, regarding the pattern of associations and the of use of psychotropic drugs.

RESUMO: Objetivo: Descrever o consumo de psicofármacos pela população adulta residente em Brumadinho, Minas Gerais, após o rompimento da barragem da Vale, ocorrido em 2019. Métodos: Trata-se de um estudo transversal, inserido no Projeto Saúde Brumadinho, desenvolvido em 2021, junto a uma amostra representativa da população adulta (18 anos ou mais) residente no município de mesmo nome. Foram incluídos na análise 2.805 indivíduos com informações sobre o uso autorreferido de psicofármacos (antidepressivos e ansiolíticos-hipnóticos/sedativos) nos últimos 15 dias. A prevalência do uso de psicofármacos foi estimada e os psicofármacos mais utilizados foram identificados. O teste do qui-quadrado de Pearson (com correção de Rao-Scott) foi utilizado para testar as associações entre exposições e o uso de psicofármacos, considerando-se o nível de significância de p<0,05. Resultados: O uso de antidepressivos (14,2%) foi mais comum do que o uso de ansiolíticos ou hipnóticos/sedativos (5,2%), sendo a sertralina e a fluoxetina os antidepressivos mais utilizados. O uso de ansiolíticos e hipnóticos/sedativos foi maior entre os moradores que residiam em área diretamente atingida pela lama da barragem, e o uso de algum psicofármaco foi maior entre aqueles que perderam algum parente/amigo no desastre e que avaliaram que sua saúde piorou após o desastre bem como entre mulheres. Conclusão: Os resultados do estudo corroboram o observado em outras populações expostas a tragédias semelhantes no que concerne às associações identificadas e ao padrão de utilização desses psicofármacos.

https://doi.org/10.1590/1980-549720220012.supl.2

The habit of drinking and driving in Brazil: National Survey of Health 2013 and 2019
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Ribeiro, Lucas Sisinno

; Damacena, Giseli Nogueira

; Souza Junior, Paulo Roberto Borges de

; Szwarcwald, Célia Landmann

Revista de Saúde Pública

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2022, Volume 56 elocation 115

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT OBJECTIVE To assess factors associated with the habit of drinking and driving and estimating the variations in the prevalence of this behavior in 2013 and 2019, considering information from the two editions of the Pesquisa Nacional de Saúde (PNS – National Survey of Health). METHODS PNS is a nationwide cross-sectional home-based study. In 2013 and 2019, 60,202 and 85,854 individuals were interviewed, respectively. To assess the association between the indicator “drinking and driving” and the study variables, crude and adjusted odds ratios (ORs) were estimated using logistic regression models. To compare the prevalence between the studied years, a Pearson’s chi-squared test adjusted by the Rao-Scott correction (which considers the effect of the sampling plan) and converted into an F statistic, tested at a 5% significance level, was used. RESULTS The prevalence of drinking and driving was higher among men in 2013 (27.4%; 95%CI 25.6–29.3%) and 2019 (20.5%; 95%CI 19.4–21.7%) than among women (11.9%; 95%CI 9.9–14.2% and 7.2%; 95%CI 6.7–9.0%, respectively). Inidviduals aged 30 to 39, who lived without a partner, in rural areas, and were motorcycle drivers had significantly higher estimates. Men with higher income had higher prevalence of drinking and driving. From 2013 to 2019, the act of drinking and driving significantly decreased. Regarding traffic accidents, ORs were significant (p < 0.01) in the studied years for both men and women. DISCUSSION Results show the need to continue policies to monitor blood alcohol level and traffic education, with specific actions directed to rural areas and motorcycle drivers.

RESUMO OBJETIVO Investigar os fatores associados ao hábito de beber e dirigir, bem como estimar as variações nas prevalências desse comportamento entre os anos de 2013 e 2019, por meio das informações das duas edições da Pesquisa Nacional de Saúde (PNS). MÉTODOS A PNS é um estudo transversal, de âmbito nacional e base domiciliar. Nos anos de 2013 e 2019, foram entrevistados, respectivamente, 60.202 e 85.854 indivíduos. Para investigar a associação entre o indicador “beber e dirigir” e as variáveis do estudo, as razões de chances (RC) brutas e ajustadas foram estimadas por meio de modelos de regressão logística. Para a comparação das prevalências entre os anos estudados, foi utilizado o teste Qui-Quadrado de Pearson ajustado pela correção de Rao-Scott (que leva em consideração o efeito do plano de amostragem) e convertido em uma estatística F, testada no nível de significância de 5%. RESULTADOS A prevalência do hábito de beber e dirigir foi maior entre os homens no ano de 2013 (27,4%; IC95% 25,6–29,3%) e no ano de 2019 (20,5%; IC95% 19,4–21,7%) do que entre as mulheres (11,9%; IC95% 9,9–14,2% e 7,2%; IC95% 6,7–9,0%, respectivamente). Estimativas significativamente mais altas foram apresentadas por pessoas de 30 anos a 39 anos, que vivem sem companheiro(a), residentes em áreas rurais e condutores de motocicleta. Maiores prevalências de beber e dirigir foram encontradas entre homens que possuem maior rendimento. Entre os anos de 2013 e 2019, foi observado um decréscimo significativo no ato de beber e dirigir. Quanto ao envolvimento em acidentes de trânsito, as RC foram significativas (p < 0,01) nos anos estudados em ambos os sexos. DISCUSSÃO Os resultados mostram a necessidade de dar continuidade às políticas de fiscalização de alcoolemia e educação no trânsito, com ações específicas dirigidas às áreas rurais e aos condutores de motocicletas.

https://doi.org/10.11606/s1518-8787.2022056004472

The habit of drinking and driving in Brazil: National Survey of Health 2013 and 2019
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Ribeiro, Lucas Sisinno

; Damacena, Giseli Nogueira

; Souza Junior, Paulo Roberto Borges de

; Szwarcwald, Célia Landmann

Revista de Saúde Pública

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2022, Volume 56 elocation 115

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.11606/s1518-8787.2022056004472

Use of psychotropic drugs by population in an area affected by the tailings dam rupture: Brumadinho Health Project
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Loyola Filho, Antônio Ignácio de

; Firmo, Josélia Oliveira Araújo

; Mambrini, Juliana Vaz de Melo

; Peixoto, Sérgio Viana

; Souza Junior, Paulo Roberto Borges de

; Nascimento, Mariana Martins Gonzaga do

Revista Brasileira de Epidemiologia

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2022, Volume 25 Suppl. 2 elocation e220012

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1980-549720220012.supl.2

Uso dos serviços de saúde e adesão ao distanciamento social por adultos com doenças crônicas na pandemia de COVID-19, Brasil, 2020
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Malta, Deborah Carvalho

; Gomes, Crizian Saar

; Silva, Alanna Gomes da

; Cardoso, Laís Santos de Magalhães

; Barros, Marilisa Berti de Azevedo

; Lima, Margareth Guimarães

; Souza Junior, Paulo Roberto Borges de

; Szwarcwald, Célia Landmann

Ciência & Saúde Coletiva

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jul 2021, Volume 26 N. 7 Pages 2833 - 2842

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Este estudo investiga a associação entre diagnóstico autorreferido de Doença Crônica Não Transmissível (DCNT) e adesão ao distanciamento social e utilização dos serviços de saúde durante a pandemia de COVID-19. Estudo transversal com adultos brasileiros que participaram da ConVid Pesquisa de Comportamentos, realizada de 24 de abril a 24 de maio de 2020, via web (n = 45.161). Considerou as DCNT: diabetes, hipertensão, doença respiratória, doença do coração e câncer. Avaliou a utilização de serviços de saúde e a adesão ao distanciamento social. Estimou as prevalências e razões de prevalências ajustadas (RPa). 33,9% (IC95%: 32,5-35,3) referiu uma ou mais DCNT. Indivíduos com DCNT tiveram maior adesão ao distanciamento social intenso (RPa:1,07; IC95%:1,03-1,11), procuraram mais o serviço de saúde (RPa:1,24; IC95%:1,11-1,38) e tiveram mais dificuldades para marcar consulta (RPa:1,52; IC95%:1,35-1,71), conseguir atendimento de saúde (RPa:1,50; IC95%:1,22-1,84) e medicamentos (RPa:2,17; IC95%:1,77-2,67), realizar exames (RPa:1,78; IC95%:1,50-2,10) e intervenções programadas (RPa:1,65; IC95%:1,16-2,34). A presença de DCNT associou-se à maior adesão ao distanciamento social, procura por atendimento de saúde e dificuldade na utilização dos serviços de saúde.

Abstract The present study investigates the association between the self-reported diagnosis of noncommunicable disease (NCD) and the adherence to social distancing and the use of health services during the COVID-19 pandemic. This was a cross-sectional study with Brazilian adults who participated in the ConVid- Behavior Survey, conducted online between April 24 and May 24, 2020(n = 45.161). This studyconsidered the following NCDs: diabetes, hypertension, respiratory disease, heart disease, and cancer, and evaluated the use of health services and the adherence to social distancing, as well as estimated the prevalences and adjusted prevalence ratio (aPR); 33,9% (95% CI: 32,5-35,3) referred to one or more NCD. Individuals with NCDsshowed a greater adherence to intense social distancing (aPR: 1,07;95% CI: 1,03-1,11), sought out health services more often (aPR:1,24; 95% CI:1,11-1,38), and found greater difficultyin scheduling doctor’s appointments (aPR:1.52; 95% CI 1,35-1,71), receiving healthcare treatment (APR:1,50;95% CI:1,22-1,84) and medication (APR:2,17;95% CI:1,77-2,67), and performing examinations (APR:1,78;95% CI:1,50-2,10) and scheduled interventions (APR:1,65;95% CI:1,16-2,34). The presence of NCDs was associated with social distancing, seeking out health care, and difficulty in using health services.

https://doi.org/10.1590/1413-81232021267.00602021 1014 downloads

Uso dos serviços de saúde e adesão ao distanciamento social por adultos com doenças crônicas na pandemia de COVID-19, Brasil, 2020
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Malta, Deborah Carvalho

; Gomes, Crizian Saar

; Silva, Alanna Gomes da

; Cardoso, Laís Santos de Magalhães

; Barros, Marilisa Berti de Azevedo

; Lima, Margareth Guimarães

; Souza Junior, Paulo Roberto Borges de

; Szwarcwald, Célia Landmann

Ciência & Saúde Coletiva

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2021, Volume 26 N. 7 Pages 2833 - 2842

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232021267.00602021

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Graft- versus -host disease
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Pereira, Andréa Z

; Vigorito, Afonso Celso

; Almeida, Alessandro de Moura

; Candolo, Alexandre de Almeida

; Silva, Ana Carolina Leão

; Brandão-Anjos, Ana Elisa de Paula

; Sá, Bianca Laselva de

; Souza, Catarina Lôbo Santos de

; Castro Junior, Cláudio Galvão de

; Oliveira, José Salvador Rodrigues de

; Barban, Juliana Bernardo

; Mancilha, Elaine Maria Borges

; Todaro, Juliana

; Lopes, Lilian Pinheiro

; Macedo, Maria Cristina Martins de Almeida

; Rodrigues, Morgani

; Ribeiro, Paulo Cesar

; Silva, Roberto Luiz da

; Roberto, Telma Sigolo

; Rodrigues, Thays de Cássia Ruiz

; Colturato, Vergilio Antonio Rensi

; Paton, Eduardo José de Alencar

; Barros, George Maurício Navarro

; Almeida, Rosana Ducatti Souza

; Moreira, Maria Claudia Rodrigues

; Flowers, Mary Evelyn

einstein (São Paulo)

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2020, Volume 18 elocation eAE4799

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO O Consenso Brasileiro de Nutrição no Transplante de Células Tronco Hematopoiéticas: doença do enxerto contra o hospedeiro foi aprovado pela Sociedade Brasileira de Transplante de Medula Óssea, com a participação de 26 centros brasileiros de transplante de células-tronco hematopoiéticas. O Consenso descreve as principais condutas nutricionais em casos de doença do enxerto contra o hospedeiro, a principal complicação do transplante de células-tronco hematopoiéticas.

ABSTRACT The Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplantation: Graft- versus -host disease was approved by Sociedade Brasileira de Transplante de Medula Óssea , with the participation of 26 Brazilian hematopoietic stem cell transplantation centers. It describes the main nutritional protocols in cases of Graft- versus -host disease, the main complication of hematopoietic stem cell transplantation.

https://doi.org/10.31744/einstein_journal/2020ae4799 1552 downloads

10.

Prevalence of arterial hypertension in Brazilian adults and its associated factors and activity limitations: a cross-sectional study
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Marques, Aline Pinto

; Szwarcwald, Célia Landmann

; de Souza-Junior, Paulo Roberto Borges

; Malta, Déborah Carvalho

; Montilla, Dalia Elena Romero

Sao Paulo Medical Journal

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jul 2019, Volume 137 N. 4 Pages 312 - 321

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Hypertension is a serious global public health problem that affects a large part of the Brazilian adult population and can cause limitations and losses of quality of life. OBJECTIVE: The objective of this study was to analyze the association of hypertension and its correlated limitations, with sociodemographic and epidemiological factors. DESIGN AND SETTING: Cross-sectional study analyzing information on 44,271 adults (30 years or older) from the Brazilian National Health Survey of 2013. METHODS: The prevalence of hypertension and the degree of limitation of the patients’ activities associated with hypertension, according to sociodemographic characteristics, anthropometric measurements and lifestyles, were calculated for both sexes. To analyze the strength of association, bivariate and multivariate Poisson regression were used. RESULTS: Hypertension was the most prevalent risk factor among Brazilian adults aged 30 years or older (40.7%). It was strongly associated with the aging process (prevalence ratio, PR 3.51), obesity (PR 1.73), heart disease (PR 1.67) and stroke (PR 1.86). Furthermore, limitations associated with hypertension were more prevalent among those with comorbidities from noncommunicable diseases relating to hypertension complications (stroke PR 1.47; heart disease PR 1.69) and with incomplete elementary education (PR 1.19). CONCLUSIONS: This study showed sociodemographic inequality in the prevalence of hypertension, especially in the population with some degree of limitation associated with hypertension. It showed that improvements in access to primary care services for controlling hypertension at its initial stages are essential in order to avoid comorbidities of greater severity and limitations and losses of quality of life, especially among socially disadvantaged people.

https://doi.org/10.1590/1516-3180.2018.0251220719 1398 downloads

11.

Factors associated with the receipt of pensions among older adults: ELSI-Brazil
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Andrade, Eli Iola Gurgel

; Cherchiglia, Mariângela Leal

; Souza Junior, Paulo Roberto Borges de

; Andrade, Fabíola Bof de

; Mambrini, Juliana Vaz de Melo

; Lima-Costa, Maria Fernanda

Revista de Saúde Pública

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2018, Volume 52 Suppl. 2 elocation 15s

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO OBJETIVO Descrever a prevalência do recebimento de aposentadorias e pensões e analisar seus fatores associados em amostra nacional da população com 50 anos ou mais. MÉTODOS Foram utilizados dados de 9.130 participantes da linha de base do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil). O desfecho foi o recebimento do benefício por qualquer fonte. As variáveis exploratórias incluíram: idade, sexo, residência por região e zona urbana ou rural, arranjos domiciliares, escolaridade, bens domiciliares, suficiência da renda, idade em que começou a trabalhar, número de doenças crônicas e limitação funcional. As regressões de Poisson e logística binária foram utilizadas nas análises. RESULTADOS A prevalência do recebimento do benefício foi de 54,3%. Na análise multivariada, os seguintes fatores apresentaram associações significantes (p < 0,05) com o recebimento do benefício: idade [razão de prevalência (RP) = 2,59 e 3,24 para 60–69 e 70 anos], residência rural (RP = 1,23), residência no Nordeste, Sul e Sudeste em comparação ao Norte (RP variando entre 1,18 e 1,23), arranjos domiciliares (RP = 1,07 e 1,15 para morar com uma pessoa e para morar só), percepção da suficiência da renda (RP = 1,08 e 1,15 para às vezes e sempre suficiente), ter doenças crônicas (RP = 1,09 e 1,17 para 1 e ≥ 2) e limitação funcional (RP = 1,13). Associação negativa foi observada para escolaridade igual a 5–8 anos (RP = 0,88). O recebimento do benefício não foi associado com a idade em que começou a trabalhar. Participantes mais jovens (50–59 anos) com ≥ 2 doenças crônicas ou limitação funcional foram 31% e 63% mais propensos a receber o benefício. Com o aumento da idade, a força dessas associações diminuiu. CONCLUSÕES Os resultados sugerem que as condições de saúde são importantes determinantes da aposentadoria ou pensão precoce. As discussões para aumentar a idade da aposentadoria não podem ser separadas daquelas acerca de melhorias das condições de saúde da população brasileira.

ABSTRACT OBJECTIVE To describe the prevalence of receipt of pensions and associated factors in a nationally representative sample of the Brazilian population aged 50 years and over. METHODS We used data from 9,130 participants from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline survey. The outcome variable was receipt of pensions from any source. The exploratory variables were age, gender, residence by region and by urban/rural area, household arrangements, schooling, household assets, perception of income sufficiency, age when started working, number of chronic diseases, and functional limitation. The analyses were based on the Poisson and binary logistic regressions. RESULTS The prevalence of the receipt of pension was 54.3%. In the multivariate analysis, the following factors showed statistically significant (p < 0.05) associations with the outcome: age [Prevalence Ratio (PR) = 2.59 and 3.24 for 60–69 and 70 years], rural residence (PR = 1.23 ), residence in the Northeast, South and Southeast compared to the North (PR ranging from 1.18 to 1.23), living arrangements (PR = 1.07 and 1.15 for living with one person and living alone), perception of income sufficiency (PR = 1.08 and 1.15 for sometimes and always), functional limitation (PR = 1.13) and having 1 and ≥ 2 chronic diseases (PR = 1,09 and 1,17). Negative association was observed for 5-8 years of education. No association between age when the individual started working and the outcome was observed. Younger participants (50–59 years old) with ≥ 2 diseases or functional limitation were 31% and 63% more likely to receive pensions, respectively; the strength of these associations declined with age. CONCLUSIONS The results suggest that health conditions are important determinants of early retirement. Discussions to increase age to the retirement cannot be separated from those on improvements in the health conditions of the Brazilian population.

https://doi.org/10.11606/s1518-8787.2018052000665 33 downloads

12.

Life course socioeconomic inequalities and oral health status in later life: ELSI-Brazil
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Andrade, Fabíola Bof de

; Antunes, José Leopoldo Ferreira

; Souza Junior, Paulo Roberto Borges de

; Lima-Costa, Maria Fernanda

; Oliveira, Cesar de

Revista de Saúde Pública

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2018, Volume 52 Suppl. 2 elocation 7s

Abstract: En | Text: En | PDF: En

ABSTRACT OBJECTIVE To investigate the association between life course socioeconomic conditions and two oral health outcomes (edentulism and use of dental prostheses among individuals with severe tooth loss) among older Brazilian adults. METHODS This was a cross-sectional study with data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) which includes information on persons aged 50 years or older residing in 70 municipalities across the five great Brazilian regions. Regression models using life history information were used to investigate the relation between childhood (parental education) and adulthood (own education and wealth) socioeconomic circumstances and edentulism and use of dental prostheses. Slope index of inequality and relative index of inequality for edentulism and use of dental prostheses assessed socioeconomic inequalities in both outcomes. RESULTS Approximately 28.8% of the individuals were edentulous and among those with severe tooth loss 80% used dental prostheses. Significant absolute and relative inequalities were found for edentulism and use of dental prostheses. The magnitude of edentulism was higher among individuals with lower levels of socioeconomic position during childhood, irrespective of their current socioeconomic position. Absolute and relative inequalities related to the use of dental prostheses were not related to childhood socioeconomic position. CONCLUSIONS These findings substantiate the association between life course socioeconomic circumstances and oral health in older adulthood, although use of dental prostheses was not related to childhood socioeconomic position. The study also highlights the long-lasting relation between childhood socioeconomic inequalities and oral health through the life course.

https://doi.org/10.11606/s1518-8787.2018052000628 33 downloads

13.

Inequalities in basic activities of daily living among older adults: ELSI-Brazil, 2015
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Andrade, Fabíola Bof de

; Duarte, Yeda Aparecida de Oliveira

; Souza Junior, Paulo Roberto Borges de

; Torres, Juliana Lustosa

; Lima-Costa, Maria Fernanda

; Andrade, Flavia Cristina Drumond

Revista de Saúde Pública

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2018, Volume 52 Suppl. 2 elocation 14s

Abstract: En | Text: En | PDF: En

ABSTRACT OBJECTIVE To evaluate the magnitude of wealth-related inequalities in basic activities of daily living among community-dwelling Brazilian older adults and to determine the contribution of demographic, socioeconomic, and health conditions to the inequality. METHODS We used data from the 2015 Brazilian Longitudinal Study of Aging (ELSI-Brazil) with a nationally representative sample of adults aged 50 years or older. We assessed wealth-related inequalities in basic activities of daily living by the concentration index. Concentration index was decomposed to determine the contribution of demographic, health, and socioeconomic factors to wealth-related inequalities in basic activities of daily living. RESULTS The prevalence of disability in the sample was 15.7% (95%CI 14.9–17.6). The concentration index was -0.145 (95%CI -0.194– -0.097), which indicates that disability is concentrated in the poorest individuals in Brazil. Inequalities in basic activities of daily living disability are primarily explained by socioeconomic status (wealth and own education) not by demographic or health factors. CONCLUSIONS There are avoidable wealth-related inequities for those with a disability in Brazil. The strong contribution of the socioeconomic status highlights the need for new public health policies that promote equity, universality, and integrality, in addition to the expansion of home nursing public services.

https://doi.org/10.11606/s1518-8787.2018052000617 27 downloads

14.

Life course and work ability among older adults: ELSI-Brazil
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Castro, Camila Menezes Sabino de

; Lima-Costa, Maria Fernanda

; César, Cibele Comini

; Neves, Jorge Alexandre Barbosa

; Andrade, Fabíola Bof de

; Souza Junior, Paulo Roberto Borges de

; Sampaio, Rosana Ferreira

Revista de Saúde Pública

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2018, Volume 52 Suppl. 2 elocation 11s

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO OBJETIVO Examinar os fatores associados à percepção da capacidade para o trabalho em amostra nacional representativa da população brasileira com 50 anos ou mais. MÉTODOS Foram utilizados dados de 8.903 participantes da linha de base do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil). A variável dependente foi a autoavaliação da capacidade para o trabalho (boa ou muito boa versus razoável, ruim ou muito ruim). As variáveis independentes incluíram fatores que operam no início, no meio e na fase atual da vida. A análise multivariada foi baseada em razões de prevalência (RP) e respectivos intervalos de confiança de 95% (IC95%) estimados por meio da regressão de Poisson. RESULTADOS A boa capacidade para o trabalho foi informada por 49% dos participantes (49,4% entre homens e 48,6% entre mulheres). Os resultados da análise multivariada mostraram que, tanto para homens quanto para mulheres, a boa capacidade para o trabalho apresentou associações positivas e estatisticamente significantes (p < 0,05) com ter saúde boa até os 15 anos de idade (RP = 1,22 e 1,18, respectivamente), escolaridade ≥ 8 anos (RP = 1,19 e 1,21, respectivamente) e autoavaliação da saúde atual como boa (RP = 1,88 e 1,94, respectivamente). Associações negativas foram observadas para idade atual (RP = 0,99 para cada incremento de um ano), diagnóstico médico de depressão (RP = 0,70 para homens e RP = 0,87 para mulheres) e ter uma ou mais doenças crônicas (RP = 0,88 para homens e 0,91 para mulheres). Apenas entre os homens, associações positivas foram observadas para idade em que começou a trabalhar (RP = 1,14 e 1,12 para 11–17 e ≥ 18 anos) e residência com o cônjuge (RP = 1,09). CONCLUSÕES A capacidade para o trabalho nas idades mais velhas é construída ao longo da vida, particularmente pelas condições de saúde na infância e na adolescência, pela idade em que os homens começam a trabalhar, pela escolaridade e pelas condições de saúde nas idades mais velhas. Políticas visando ao aumento da longevidade no mercado de trabalho devem levar em conta esses fatores.

ABSTRACT OBJECTIVE To examine factors associated with perception of work ability in a nationally representative sample of Brazilians aged 50 years and over. METHODS We used data from 8,903 participants of the baseline survey of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The dependent variable was self-rated work ability (good or very good versus fair, poor, or very poor). Independent variables included factors that operate at the beginning, middle, and current stage of life. Multivariate analysis was based on prevalence ratios (PR) and 95% confidence intervals (95%CI) estimated by Poisson regression. RESULTS Good work ability was reported by 49% of \ participants (49.4% among men and 48.6% among women). Results of the multivariate analysis showed that, for both men and women, good work ability showed positive and statistically significant associations (p < 0.05) with good health up to 15 years of age (PR = 1.22 and 1.18 , respectively), educational level ≥ 8 years (PR = 1.19 and 1.21, respectively), and current good self-rated health (PR = 1.88 and 1.94, respectively). Negative associations were observed for current age (PR = 0.99 for each increase of one year among men and women), medical diagnosis of depression (PR = 0.70 for men and PR = 0.87 for women), and having one or more at least chronic diseases (PR = 0.88 for men and 0.91 for women). Only for men, positive associations for the age at which they started working (PR = 1.14 and 1.12 for 11–17 and ≥ 18 years, respectively) and living with a spouse (PR = 1.09) were found. CONCLUSIONS Work ability in older ages is built over the life course, particularly by the health conditions in childhood and adolescence, age at which men begin working, educational level, and health conditions in older ages. Policies aimed at increasing longevity in the labor market must take these factors into account.

https://doi.org/10.11606/s1518-8787.2018052000648 33 downloads

15.

Primary care and healthcare utilization among older Brazilians (ELSI-Brazil)
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Macinko, James

; Andrade, Fabíola Bof de

; Souza Junior, Paulo Roberto Borges de

; Lima-Costa, Maria Fernanda

Revista de Saúde Pública

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2018, Volume 52 Suppl. 2 elocation 6s

Abstract: En | Text: En | PDF: En

ABSTRACT OBJECTIVE To characterize healthcare access and utilization among older Brazilians. METHODS Data are from the baseline wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which is a nationally representative, population-based cohort study of persons aged 50 years and older conducted in 2015/2016 (n = 9,412). The prevalence of barriers to primary care and number and type of doctor visits in the past 12 months are compared by three main sources of healthcare (private, Family Health Strategy, traditional public clinics). Two-part multivariable hurdle analyses assess the relation between healthcare utilization, primary care problems, and source of healthcare, while controlling for healthcare determinants. RESULTS Females comprised 54% of the sample, with a mean age of 63 years. There were no demographic differences by source of healthcare. Nearly 83% had at least one doctor visit in the past 12 months, with higher use among private health plan holders. Private health plan holders most frequently visited specialists, while those using the public system were more likely to visit a general practitioner. Primary care barriers averaged 3.5 out of 12 and were the highest among those using traditional health posts. A greater number of primary care problems was negatively associated with all types of healthcare utilization. CONCLUSIONS By international standards, access to basic healthcare among older Brazilians is relatively high. Nevertheless, different levels of primary care problems between the public and private sectors and resulting utilization patterns suggest the need to continue working to close remaining gaps.

https://doi.org/10.11606/s1518-8787.2018052000595 30 downloads

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