Caroline Senicato

Social inequality in health among women in Campinas, São Paulo State, Brazil

The aim of this study was to assess social inequalities in health status and use of health services according to level of schooling in women. This was a cross-sectional population-based study with a sample of 508 women from 20 to 59 years of age living in Campinas, São Paulo State, Brazil (ISA-Camp 2008). Women with less schooling showed higher prevalence of hypertension, circulatory problems, headache, dizziness, obesity, common mental disorders, worse self-rated health, use of dental prosthesis, and visual impairment, but lower prevalence for use of eyeglasses. There were no differences between the two schooling strata in prevalence of medical visits in the previous two weeks, use of medicines in the three previous days, Pap smear, breast self-examination, clinical breast examination, hospitalizations and surgeries in the previous year, and rubella vaccination any time in life. The only significant differences were in use of dental services and mammograms. The results show social inequalities in various health indicators and equity in access to various components of the health services.

Transtorno mental comum em mulheres adultas: identificando os segmentos mais vulneráveis

This study aimed to evaluate the socioeconomic and demographic factors, behaviors and morbidities related to common mental disorders in adult women. This was a cross-sectional population-based study with cluster sample. We analyzed 848 women from a household survey held in Campinas, in 2008/2009. We used the Self-Reporting Questionnaire (SRQ-20) to evaluate common mental disorders. We estimated prevalence ratios by Poisson regression in hierarchical model of three steps, considering the weights relating to the sampling design. The prevalence of common mental disorders was 18.7%. The hierarchical model showed that older women, with low education level, housewives, separated or widowed, who did not consume fruit/vegetables daily, who slept six or fewer hours per night, who presented several chronic diseases and health problems, and with report of some type of violence were more vulnerable to common mental disorders and, therefore, should be treated with priority by health services. Early diagnosing women with common mental disorders, as well as accompanying and treating them, contribute for reducing the impacts on female quality of life.

Ser trabajadora remunerada o ama de casa se asocia a la calidad de vida relacionada con la salud

Considerando que nao ha estudos brasileiros que avaliem a relacao entre a insercao no mercado de trabalho e a qualidade de vida relacionada a saude (QVRS) de mulheres, objetivou-se com a presente pesquisa verificar se existe associacao entre ter ou nao trabalho remunerado e a QVRS das mulheres, e, se o estrato socioeconomico modifica esta associacao. Trata-se de estudo transversal de base populacional com amostra de 668 mulheres de 18 a 64 anos do Inquerito de Saude de Campinas (ISACamp 2008/2009), utilizando-se o SF-36 para avaliar a QVRS. Ser dona de casa esteve associado a pior QVRS, sobretudo nos aspectos mentais, mas esta associacao e modificada pelo nivel socioeconomico. Nos segmentos de intermediaria e baixa escolaridade e renda familiar, as donas de casa apresentaram pior QVRS que as trabalhadoras remuneradas, mas nao houve diferenca entre os dois segmentos nos estratos de alta escolaridade e renda. A pior QVRS das donas de casa enfatiza a importância de politicas publicas que visem a ampliar as oportunidades de insercao da mulher no mercado de trabalho e de acesso a educacao.

Ser trabalhadora remunerada ou dona de casa associa-se à qualidade de vida relacionada à saúde?

Considerando que nao ha estudos brasileiros que avaliem a relacao entre a insercao no mercado de trabalho e a qualidade de vida relacionada a saude (QVRS) de mulheres, objetivou-se com a presente pesquisa verificar se existe associacao entre ter ou nao trabalho remunerado e a QVRS das mulheres, e, se o estrato socioeconomico modifica esta associacao. Trata-se de estudo transversal de base populacional com amostra de 668 mulheres de 18 a 64 anos do Inquerito de Saude de Campinas (ISACamp 2008/2009), utilizando-se o SF-36 para avaliar a QVRS. Ser dona de casa esteve associado a pior QVRS, sobretudo nos aspectos mentais, mas esta associacao e modificada pelo nivel socioeconomico. Nos segmentos de intermediaria e baixa escolaridade e renda familiar, as donas de casa apresentaram pior QVRS que as trabalhadoras remuneradas, mas nao houve diferenca entre os dois segmentos nos estratos de alta escolaridade e renda. A pior QVRS das donas de casa enfatiza a importância de politicas publicas que visem a ampliar as oportunidades de insercao da mulher no mercado de trabalho e de acesso a educacao.

[Are there differences between paid women workers and housewives in health-related quality of life?].

Considerando que nao ha estudos brasileiros que avaliem a relacao entre a insercao no mercado de trabalho e a qualidade de vida relacionada a saude (QVRS) de mulheres, objetivou-se com a presente pesquisa verificar se existe associacao entre ter ou nao trabalho remunerado e a QVRS das mulheres, e, se o estrato socioeconomico modifica esta associacao. Trata-se de estudo transversal de base populacional com amostra de 668 mulheres de 18 a 64 anos do Inquerito de Saude de Campinas (ISACamp 2008/2009), utilizando-se o SF-36 para avaliar a QVRS. Ser dona de casa esteve associado a pior QVRS, sobretudo nos aspectos mentais, mas esta associacao e modificada pelo nivel socioeconomico. Nos segmentos de intermediaria e baixa escolaridade e renda familiar, as donas de casa apresentaram pior QVRS que as trabalhadoras remuneradas, mas nao houve diferenca entre os dois segmentos nos estratos de alta escolaridade e renda. A pior QVRS das donas de casa enfatiza a importância de politicas publicas que visem a ampliar as oportunidades de insercao da mulher no mercado de trabalho e de acesso a educacao.

Rubella vaccination in women of childbearing age in Campinas, São Paulo State, Brazil

Women of reproductive age are the population of greatest interest for the prevention of congenital rubella syndrome. The aim of this study was to evaluate the prevalence of rubella vaccination in women and to identify factors associated and motives for non-adherence. A cross-sectional population-based study, in Campinas, São Paulo State, Brazil, in 2008/2009, was carried out with stratified random, two-stage cluster sampling. Of the 778 women aged 10 to 49 years, 83.8% (95%CI: 79.6-88.0) reported vaccination in life. Age group (20-39 years), per capita household income greater than 3 times the minimum wage and orientation of health care professionals about the vaccine, were positively associated with rubella vaccination. The main motives for non-adherence were lack of orientation of professionals about their importance (48.5%) and not consider it necessary (18.9%). The recommendation of professionals was the factor most strongly associated with womens adherence to vaccination. In this sense, an indication of vaccination by health care teams can increase the knowledge about the importance their and benefits.

Vacinação contra rubéola em mulheres em idade reprodutiva no Município de Campinas, São Paulo, Brasil

This study analyzed common mental disorders in the elderly according to demographic and socioeconomic characteristics, health-related behavior, and disease history. This was a cross-sectional, population-based study with a cluster sample using data from a health survey conducted in Campinas, São Paulo State, Brazil, in 2008. SRQ-20 was used to evaluate common mental disorders. Adjusted prevalence ratios were estimated using multiple Poisson regression. Prevalence of common mental disorders was 29.7%, and higher rates were associated with female gender, age 80 years or older, lower income, not working, sedentary lifestyle, poor self-rated health, and greater number of chronic diseases. Prevalence ratios were higher in the subscale of depressive thinking. The results provide direct backing for planning interventions focused on health of the elderly, with an emphasis on elderly that work and follow healthy lifestyles. The study highlights the need for attention by health professionals to depressive disorder in the elderly.Analisou-se o transtorno mental comum em idosos segundo variaveis demograficas, socioeconomicas, de comportamentos relacionados a saude e morbidades. Trata-se de estudo transversal de base populacional, com amostra por conglomerados. A pesquisa utilizou dados de inquerito de saude realizado em Campinas, Sao Paulo, Brasil, em 2008. Foi usado o questionario SRQ-20 para avaliar o transtorno mental comum. Foram estimadas razoes de prevalencias ajustadas por meio de regressao multipla de Poisson. A prevalencia de transtorno mental comum foi 29,7% e significativamente mais elevada no sexo feminino, nos idosos com 80 anos ou mais, menor renda, que nao trabalhavam, sedentarios, que avaliaram sua saude como ruim/muito ruim e com maior numero de doencas cronicas. Maiores razoes de prevalencias foram detectadas na subescala de pensamentos depressivos. Os resultados trazem subsidios para o planejamento de intervencoes voltadas a saude dos idosos, com enfase nos idosos que trabalham e com habitos de vida saudaveis. Apontam a necessidade de atencao dos profissionais para o quadro depressivo na terceira idade.As mulheres em idade reprodutiva sao a populacao de maior interesse para a prevencao da sindrome da rubeola congenita. O objetivo do trabalho foi avaliar a prevalencia de vacinacao contra rubeola em mulheres e identificar fatores associados e motivos da nao adesao. Trata-se de estudo transversal de base populacional, realizado em Campinas, Sao Paulo, Brasil, em 2008/2009, com amostra por conglomerados e em dois estagios. Das 778 mulheres de 10 a 49 anos, 83,8% (IC95%: 79,6-88,0) referiram vacinacao em algum momento da vida. Faixa etaria (30-39 anos), renda familiar per capita superior a tres salarios minimos e a orientacao de profissional de saude estiveram positivamente associadas a vacinacao contra a rubeola. Os principais motivos da nao adesao foram a falta de orientacao do profissional de saude sobre sua importância (48,5%) e nao considera-la necessaria (18,9%). A recomendacao do profissional de saude foi o fator mais fortemente associado a adesao das mulheres a vacinacao. Nesse sentido, sua indicacao pelas equipes de saude pode ampliar o conhecimento sobre sua importância e seus beneficios.

P2-371 Social inequality in health among women

Introduction Increased involvement in the job market has added new responsibilities to traditional female roles, which are reflected in quality of life and health, but are manifested in a distinct fashion in this social segment. The present study assessed the health status and use of healthcare services of women between 20 and 59 years of age according to social strata based on level of schooling (< 9 and 9+ years of study). Methods A population-based cross-sectional study was carried out with conglomerate sampling. Five hundred eight women were analysed from a home survey carried out in Campinas, SP, Brazil in 2008. Prevalence values were estimated and prevalence ratios were adjusted using Poisson regression and considering weights related to the sampling design. Results Women with a lower level of schooling had a poorer quality of life and greater prevalence values for hypertension (PR=1.63), circulatory problems (PR=1.92), dizziness (PR=1.92), headaches (PR=1.77), common mental disorders (PR=2.16) and a worse self-assessment of health (PR=2.44). No differences between groups were found regarding medical appointments in the previous 2 weeks, hospitalisations and surgeries in the previous year, self and clinical breast exams, Papanicolaou test and vaccine for rubella. Significant differences were found in the percentage of dental appointments and mammograms. Conclusion Social inequalities were found in the prevalence of health problems, but no inequalities were found regarding various indicators of the use of healthcare services, which must be the fruit of the adequate structuring of the Brazilian public healthcare system in the city investigated.