Ademar Arthur Chioro dos Reis

A Cobertura da Estratégia de Saúde da Família (ESF) no Brasil, segundo a Pesquisa Nacional de Saúde, 2013

OBJECTIVE to present Family Health Strategy (ESF) coverage according to the National Health Survey (PNS), comparing to administrative data and previous coverage of the National Household Sample Survey (PNAD 2008), and describe the frequencies of home visiting teams. METHODS it was compared data from 2013 according to PNS and data from the Ministry of Health and the National Household Sample Survey (PNAD 2008). Home visiting indicators of PNS were stratified by education and Major Regions. RESULTS the proportion of households registered in Family Health Teams in Brazil was 53.4% (95%CI: 52.1-54.6), being higher in rural areas and in the Northeast. The proportion of residents in registered households was 56.2%, similar to the Ministry of Health (56.4%) and showed growth compared to PNAD 2008 (50.9%). There was variation between regions, UF and capitals. People with lower education level have received more home visiting monthly. DISCUSSION the ESF is an important promoter of health equity and its coverage and scope increase is successful in the country.

Consumo de bebidas alcoólicas e direção de veículos, balanço da lei seca, Brasil 2007 a 2013

The study analyzes the trend in frequency of adults who drive under the influence of alcohol in major Brazilian cities after the passing of laws, which prohibit drunk driving. Data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL) between 2007 and 2013 were analyzed. The frequency of adults who drove after abusive alcohol consumption was reduced by 45.0% during this period (2.0% in 2007 to 1.1% in 2013). Between 2007 and 2008 (-0.5%) and between 2012 and 2013 (-0.5%), significant reductions were observed in the years immediately after the publication of these laws that prohibit drunk driving. These improvements towards the control of drunk driving show a change in the Brazilian population’s lifestyle.The study analyzes the trend in frequency of adults who drive under the influence of alcohol in major Brazilian cities after the passing of laws, which prohibit drunk driving. Data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL) between 2007 and 2013 were analyzed. The frequency of adults who drove after abusive alcohol consumption was reduced by 45.0% during this period (2.0% in 2007 to 1.1% in 2013). Between 2007 and 2008 (-0.5%) and between 2012 and 2013 (-0.5%), significant reductions were observed in the years immediately after the publication of these laws that prohibit drunk driving. These improvements towards the control of drunk driving show a change in the Brazilian population’s lifestyle.

Smoking trend indicators in Brazilian capitals, 2006-2013

This study aims to analyze the trend of indicators related to smoking in the capitals of Brazil from 2006 to 2013. Information on smoking trends extracted from the survey of risk and protective factors for chronic non-communicable diseases (NCDs) are analyzed through telephone interviews - VIGITEL conducted from 2006-2013 for the adult population in Brazilian capitals. To estimate the trend, the simple linear regression model was used. The prevalence of smokers in Brazil showed a relative reduction of 0.62% for each year of the survey, ranging from 15.6% in 2006 to 11.3% in 2013. A decrease was observed in both sexes in all age ranges except between 55 and 64 years in all education levels and regions. The total population of former smokers remained stable, with a reduction for men. Smoking 20 or more cigarettes per day decreased from 4.6% (2006) to 3.4% (2013), or 0.162 percentage points per year. Passive smoking at home decreased among women 13.4% (2009) to 10.7% (2013), a reduction of 0.72% per annum. Passive smoking at work has remained stable over the period. The smoking trend reduced in the period in most indicators, reflecting the importance of the tobacco control actions in the country.

A vigilância e o monitoramento das principais doenças crônicas não transmissíveis no Brasil - Pesquisa Nacional de Saúde, 2013

OBJECTIVE To describe the major noncommunicable diseases (NCDs) in Brazil, according to the information collected from individuals aged 18 years or older. METHODS Data from the National Health Survey (PNS), 2013, a transversal population-based study, were used. The proportions of each NCD were calculated and presented according to sex, with a 95% confidence interval (95%CI), with the absolute values. RESULTS Of the total respondents, 45.1% reported presenting at least one NCD. The region with the highest prevalence of NCDs was the South (52.1%). Hypertension showed the highest prevalence among NCDs, with 21.4%, followed by chronic back problem (18.5%), depression (7.6%), arthritis (6.4%), and diabetes (6.2%). The intense/very intense degree of limitation showed a higher prevalence of other mental illnesses (37.6%) and cerebrovascular accident (25.5%). CONCLUSION The improvement of health services is essential for an effective response to the double burden of illness in the middle- and low-income countries.

Política Nacional de Promoção da Saúde (PNPS): capítulos de uma caminhada ainda em construção

Health is a fundamental human right, according to the global commitment to the Universal Declaration of Human Rights. Health is a public good socially produced by and within social networks and disputes among subjects that seek to place certain interests and needs on the agenda of public policies. Health Promotion, as a set of strategies and forms of producing health, both individual and collective, aiming to meet the social needs of health and to assure better quality of life of the population, emerges intrinsically marked by tensions inherent to the defense of the right to health. The present article intends to detail a certain pathway of Health Promotion at SUS, telling the history of its affirmation as a National Policy and the possibilities that were produced therein to amplify the completeness of healthcare. The authors, totally involved in the preparation, implementation, and revision of the National Health Promotion Policy (PNPS), classified the journey into three chapters: (1) 1998/2004 – Embryo of a PNPS; (2) 2005/2013 – Birth, growth, and development of a PNPS; (3) 2013-2015 – Revision, expansion and dissemination of the PNPS. In addition to the narrative of a history, the cycle analysis of a policy, or balance of advancements, there is an attempt to restore contexts, texts, speeches, and tensions in the PNPS trajectory. The next chapters are still ongoing, and announce paths and possibilities on how to ensure that a Policy is kept alive.

Fatores de risco e proteção para doenças crônicas por inquérito telefônico nas capitais brasileiras, Vigitel 2014

Objective: To describe the prevalence of risk and protective factors for chronic diseases in Brazilian adult population in 2014 and investigate the associated sociodemographic factors. Methods: Analyses were performed based on data from telephone interviews (Vigitel 2014) on probabilistic samples of adult population (≥ 18 years old) from the capitals of the 26 Brazilian States and the Federal District, living in households with landline phones. Prevalence is presented by gender, age and educational level, and adjusted prevalence ratios (PR) are estimated using Poisson Regression model. Results: Among the 40.853 adults who were interviewed, 10.8% were smokers and 21.2% ex-smokers. Among the respondents, 16.5% reported alcohol abuse and 52.5% were overweight, factors that were more frequent among men. The prevalence of recommended intake of fruits and vegetables was 24%, intake of sweets was 18.1% and replacements of main meals for snacks was 16.2%, factors that were higher among women. Leisure time physical activity reached 35.3% and increased with the level of education. Hypertension was the most frequent disease achieving 24.8%, which was higher among women and increased with age. Conclusion: The results from Vigitel 2014 indicate that risk factors are, in general, more frequent among men, older adults and less educated individuals, characterizing the socioeconomic and cultural dimensions in determining chronic diseases.OBJECTIVE To describe the prevalence of risk and protective factors for chronic diseases in Brazilian adult population in 2014 and investigate the associated sociodemographic factors. METHODS Analyses were performed based on data from telephone interviews (Vigitel 2014) on probabilistic samples of adult population (≥ 18 years old) from the capitals of the 26 Brazilian States and the Federal District, living in households with landline phones. Prevalence is presented by gender, age and educational level, and adjusted prevalence ratios (PR) are estimated using Poisson Regression model. RESULTS Among the 40.853 adults who were interviewed, 10.8% were smokers and 21.2% ex-smokers. Among the respondents, 16.5% reported alcohol abuse and 52.5% were overweight, factors that were more frequent among men. The prevalence of recommended intake of fruits and vegetables was 24%, intake of sweets was 18.1% and replacements of main meals for snacks was 16.2%, factors that were higher among women. Leisure time physical activity reached 35.3% and increased with the level of education. Hypertension was the most frequent disease achieving 24.8%, which was higher among women and increased with age. CONCLUSION The results from Vigitel 2014 indicate that risk factors are, in general, more frequent among men, older adults and less educated individuals, characterizing the socioeconomic and cultural dimensions in determining chronic diseases.

Tendência de fumantes na população Brasileira segundo a Pesquisa Nacional de Amostra de Domicílios 2008 e a Pesquisa Nacional de Saúde 2013

OBJECTIVE To compare current tobacco smoking prevalence in the Brazilian population and the federal states in adults (aged ≥ 18 years), using the National Household Survey 2008 and National Health Survey, 2013. METHODS Using data from two national surveys conducted in 2008 and 2013, the paper examines the current tobacco smoking prevalence in Brazil at the national level and at the federal state level. We calculated the percentage change for the period. RESULTS Overall, results show -19% reduction in current tobacco smoking prevalence from 18.5% (2008) to 14.7% (2013). Results also show a significant percentage decline in smoking prevalence across geographic regions and demographic characteristics including gender, race, age and education levels. The decline occurred in all regions, urban and rural areas, and in most states. The reduction was -17.5% for men and -20.7% for women, having occurred in all age groups, with the greatest reduction in the group from 25 to 39 years of age; in all categories of race/color, a higher prevalence was found among the blacks and browns. It also declined in all the levels of schooling, with a higher reduction in lower education levels. In 2013, the prevalence for people with less education was 19.7% and 8.7% for those with college degrees. CONCLUSION There was an average reduction of about 19% in tobacco consumption in Brazil and the Brazilian states in both sexes, all ages, and race color. Tobacco consumption in the country is one of the lowest in the world and has declined significantly, which can be attributed to the control policies, regulation, and prevention.

Os usuários e a transição tecnológica no setor de saúde suplementar: estudo de caso de uma operadora de plano de saúde

O artigo apresenta os resultados de investigacao realizada junto a usuarios do case management, programa desenvolvido por uma empresa de medicina de grupo para o cuidado de pacientes vivendo situacao de alta vulnerabilidade. Buscou-se construir uma perspectiva na qual a experiencia do usuario, ao inves de representar apenas uma informacao adicional ou superposta a qualidade dos servicos, e considerada parte indissociavel do arranjo estudado, com potencia para iluminar qualidades e contradicoes internas. Os resultados mostram como os pacientes dao alto valor aos cuidados recebidos, com especial enfase no vinculo criado com a equipe responsavel, mesmo que apenas por via telefonica. Ao mesmo tempo, conseguem perceber a dupla face regulacao/modelo assistencial presente no arranjo tecnologico estudado, sobretudo o quanto o forte vies economico de reducao de custo que preside sua operacionalizacao impacta na qualidade final do cuidado.

Estilos de vida da população brasileira: resultados da Pesquisa Nacional de Saúde, 2013

OBJETIVO:descrever os estilos de vida da populacao brasileira quanto a alimentacao, atividade fisica, consumo de alcool e tabagismo.METODOS:estudo descritivo com dados da Pesquisa Nacional de Saude 2013, que coletou informacoes em 64.348 domicilios; foram calculadas prevalencias e intervalos de confianca de 95% (IC95%) na populacao ≥18 anos de idade.RESULTADOS:a prevalencia do consumo de frutas e hortalicas foi de 37,3% (IC95%: 36,4%- 38,1%), do consumo excessivo de gorduras, 37,2% (IC95%: 36,4%- 38,0%), de refrigerantes, 23,4% (IC95%: 22,7%- 24,1%) e de feijao, 71,9% (IC95%: 71,2%- 72,6%); a pratica de atividade fisica no tempo livre foi observada em 22,5% dos adultos (IC95%: 21,8%- 23,1%); a prevalencia de tabagismo foi 14,5% (IC95%: 14,0%- 15,0%) e o consumo abusivo de alcool, 13,7% (IC95%: 13,1%- 14,2%).CONCLUSAO:verificou-se elevadas prevalencias de fatores de risco para doencas cronicas nao transmissiveis em adultos.OBJECTIVE:to describe lifestyles of the Brazilian population with regard to nutrition, physical activity, alcohol consumption and tobacco smoking.METHODS:this was a descriptive study using National Health Survey (2013) data collected from 64.348 households. Lifestyle Indicators prevalences and 95% confidence intervals were calculated for people aged 18 years or older.RESULTS:prevalences were as follows: Fruits and vegetables 37.3°% (95%CI: 36.4%-38.1%); excessivefat consumption 37.2% (95%CI: 36.4%-38.0%), soft drinks 23.4% (95%CI: 22.7%-24.1%%); beans 71.9% (95%CI: 71.2%-72.6%); practicing physical activity during leisure time was observed in 22.5% of adults (95%CI: 21.8%-23.1%); smoking 14.5% (95%CI: 14.0%-15.0%); alcohol abuse 13.7% (95%CI: 13.1%-14.2%).CONCLUSION:high prevalences of risk factors for non-communicable chronic diseases in adults were found.

Injuries from traffic accidents and use of protection equipment in the Brazilian population, according to a population-based study.

The article aims to describe the injuries in traffic according to demographic characteristics, use of protective equipment, use of health services, activity limitations and disabilities. The percentage involvement in traffic accidents with injuries, the percentage of use of protective equipment, use of health services, limitation of daily activities, disability and sequelae, according to educational level, race, color, sex, age and region of residence it estimated.The use of safety belt in the adult population was 79.4%and 50.2% in the front seats and back, respectively; the helmet use among motorcycle drivers and passengers were respectively 83.4 and 80.1. Safety equipment are less used in the North and Northeast and in the countryside. Reported car accident last month 3.1%, being higher in males 4.5%, the people of complete primary schooling and School graduate, young adult and the brown race-color. Among the injured received some form of health care due to this accident 52.4%, were admitted 7.7%. They reported having had limitation of daily activities, disabilities and consequences arising from traffic accidents 14.1%. Car accidents are high in the country.