Aloyzio Cechella Achutti

Fatores de risco para doenças não-transmissíveis em área metropolitana na região sul do Brasil: prevalência e simultaneidade

Tres quartos da mortalidade no Estado do Rio Grande do Sul (Brasil) ocorrem por doencas nao-transmissiveis. Dentre elas as doencas cardiovasculares, por si so, correspondem a 35% das causas de morte. Para avaliar a prevalencia de fatores de risco para essas doencas, foi realizado inquerito domiciliar no periodo de 1986/87. Foram entrevistados 1.157 individuos entre 15-64 anos, residentes em setores censitarios de 4 areas docente-assistenciais do Municipio de Porto Alegre, RS. A prevalencia padronizada de tabagismo foi de 40%, hipertensao 14%, obesidade 18%, sedentarismo geral 47% e consumo excessivo de alcool, 7%. Trinta e nove por cento da amostra acumulavam dois ou mais desses cinco fatores de risco, somente 22% de homens e 21% de mulheres nao apresentaram esses fatores de risco. As elevadas frequencias e concomitâncias desses fatores de risco alertam para sua importância em programas que visam a prevencao das doencas nao-transmissiveis.

Mortalidade precoce por doenças cardiovasculares e desigualdades sociais em Porto Alegre : da evidência à ação

BACKGROUND: Two perspectives, the economic (disease causing impoverishment) and social (poverty causing illness), have internationally disputed the justification for public health policies. OBJECTIVE: To investigate the relationship between early mortality by cardiovascular disease (CVD) and socioeconomic (SE) conditions in the city of Porto Alegre (PA), and discuss bases and strategies for the prevention of CVD. METHODS: An ecological analysis of the association between mortality by CVD at 45-64 years of age and SE conditions of 73 districts/neighborhoods in PA. The relative risk (RR) and the fraction of risk (FRA) attributable to inequality among the districts grouped into 4 SE strata were estimated. RESULTS: Early mortality by CVD was 2.6 times higher in the districts classified in the worst compared to the best of the 4 SE strata. Among the extreme districts, the RR reached 3.3 for CVD and 3.9 for cerebrovascular disease. Compared to the mortality in the best stratum, 62% of the early deaths in the worst stratum and 45% of those in the city as a whole could be attributed to socioeconomic inequality. CONCLUSION: Almost half of the mortality by CVD before 65 years of age can be attributed to poverty. Disease, on the other hand, contributes towards poverty and reduces competitiveness of the country. It is necessary to reduce illness and recover the health of the poorest inhabitants with investments that result in national economic development and improvement of the social conditions of the population.

Doenças crônicas não-transmissíveis no Brasil: repercussões do modelo de atenção à saúde sobre a seguridade social

A seguridade social envolve acoes do poder publico e da sociedade sobre direitos a previdencia social, a assistencia social e a propria saude. Este artigo traca um esboco de cada um desses elementos. Muitas doencas cronicas nao-transmissiveis tem fatores de risco comuns e demandam assistencia continuada de servicos. Comparando-se nossa populacao com a dos EUA, ve-se que e praticamente do mesmo tamanho ate a faixa dos 15 aos 24 anos. A americana e duas vezes maior dos 35 aos 44 anos e mais de quatro vezes maior acima dos 75 anos. Tais diferencas explicam porque o numero de mortes por DCNT e muito mais baixo no Brasil: nossa populacao e mais jovem e morre antes. Na medida em que o processo de envelhecimento avance, especialmente, via reducao da mortalidade precoce, aumentara a prevalencia das DCNT e sua repercussao na seguridade social. Assim como a atencao a saude, a previdencia social e a assistencia social sofrem pressoes politicas, economicas e culturais. Na tentativa de imaginar um cenario futuro possivel para a seguridade social no Brasil discute-se a necessidade de reformular o orcamento do Pais, visando ao equilibrio financeiro.

Information and communication technology in cardiovascular disease prevention in developing countries: hype and hope. Report of the International Collaboration on Information Use in Cardiovascular Health Promotion in Developing Countries.

Information can be an important tool in promoting a prevention strategy to address the emerging epidemic of cardiovascular disease in developing countries. Advances in information and communication technology offer new promises for global access to information and for global mobilization to prevent and control cardiovascular disease. This is especially true for health professionals, whose needs in areas such as networking, exchange of expertise and access to relevant advances remain unfulfilled. Information technology can also sensitize the lay public to the magnitude of cardiovascular diseases, creating awareness about risk states, and highlighting preventive strategies. Effective application mandates that the technology be relevant to local needs. Cost, feasibility, and relevance of information need to be considered before wide adoption is advocated. Several initiatives, such as ProCOR, Global Cardiovascular Infobase, Heartfile, and the Virtual Congress of Cardiology, have successfully utilized information technology to promote cardiovascular prevention. The experience of these initiatives suggests that, while information technology holds great potential, there are many potential perils, such as the widening global information gap, inequitable access, and irrelevant information. For now, information technology must be viewed as part of a broader strategy, which includes conventional communication media, to address the unmet information needs for cardiovascular prevention globally. Enlightened policies can exploit the energies of the recent information boom for promoting cardiovascular prevention, taking into account the considered limitations.

Health indicators in Brazil

Felizmente, hoje ja se dispoem de bons dados sobre saude e doenca para nossa populacao2,3 que podem ser trabalhados, como nesse artigo, para transforma-los em indicadores, para melhor compreender nossa realidade e para definir politicas de saude. Saimos de uma epoca na qual so se discutiam dados de mortalidade provenientes de outros paises, tentando grosseiramente extrapola-los para nossa populacao. Passamos tambem por um periodo no qual o descredito em nossas informacoes servia como pretexto para ignora-las. Somente utilizando e discutindo a informacao se consegue melhora-la.

Gramado Declaration: The Impact of 20 Years of Cardiovascular Prevention

The initiative came from the Scientific Advisory Board of the Faculty of Medicine of the Universidade Federal of Rio Grande do Sul (UFRGS) and the Cardiology Clinical Department and of the Committe de Epidemiology and Public Health of the Sociedade Brasileira de Cardiologia (SBC), under the auspices of the Coordination of Higher Education for Personal Development (CAPES), the World Heart Federation (at that time still called the International Society and Federation of Cardiology) and the Inter-American Heart Foundation.

Rapid Assessment of Tobacco Consumption and Prevalence

In developing countries without sufficient epidemiological data about tobacco consumption and prevalence, there is in general good information about the tobacco agro-industry, and on economic profits from them. We can easily get data on land areas used for plantations, production and productivity, the number of workers involved and the number of farms growing tobacco, the number of industries, the quantity of cigarettes produced, imports and exports, taxes earned by the government and profits.