Jorge Alexandre Barbosa Neves

Life Course Socioeconomic Position and C-Reactive Protein: Mediating Role of Health-Risk Behaviors and Metabolic Alterations. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Background Chronic inflammation has been postulated to be one mediating mechanism explaining the association between low socioeconomic position (SEP) and cardiovascular disease (CVD). We sought to examine the association between life course SEP and C-reactive protein (CRP) levels in adulthood, and to evaluate the extent to which health-risk behaviors and metabolic alterations mediate this association. Additionally, we explored the possible modifying influence of gender. Methods and Findings Our analytical sample comprised 13,371 participants from ELSA-Brasil baseline, a multicenter prospective cohort study of civil servants. SEP during childhood, young adulthood, and adulthood were considered. The potential mediators between life course SEP and CRP included clusters of health-risk behaviors (smoking, low leisure time physical activity, excessive alcohol consumption), and metabolic alterations (obesity, hypertension, low HDL, hypertriglyceridemia, and diabetes). Linear regression models were performed and structural equation modeling was used to evaluate mediation. Although lower childhood SEP was associated with higher levels of CRP in adult life, this association was not independent of adulthood SEP. However, CRP increased linearly with increasing number of unfavorable social circumstances during the life course (p trend <0.001). The metabolic alterations were the most important mediator between cumulative SEP and CRP. This mediation path accounted for 49.5% of the total effect of cumulative SEP on CRP among women, but only 20.2% among men. In consequence, the portion of the total effect of cumulative SEP on CRP that was mediated by risk behaviors and metabolic alterations was higher among women (55.4%) than among men (36.8%). Conclusions Cumulative SEP across life span was associated with elevated systemic inflammation in adulthood. Although health-risk behaviors and metabolic alterations were important mediators of this association, a sizable fraction of this association was not mediated by these factors, suggesting that other pathways might play a role, especially among men.

Superando a pobreza: o papel do capital social na região metropolitana de Belo Horizonte

This article approaches the role of the social capital in the overcoming of the poverty in urban areas. Different of other studies that adopt a macro perspective for social capital, this article analyzes it as something inherent to the interactions between individuals, being capable to bring individual returns. Social capital is measured on the basis of the association of the individuals in diverse types of social organizations. The hypothesis, of that, exactly controlling for human capital and socioeconomic origin variables, how much bigger the individual reserve of social capital, bigger will be its possibility to get an income that allows it to surpass the poverty line, was tested by means of a logistic regression model, that evaluate the effect of variables in the probability of an individual surpass the poverty line. The data for this study are secondary (2002 edition of the Research of the Metropolitan Region of Belo Horizonte/UFMG/BRAZIL). The results show that to be a member of social organizations has a significant effect in the possibilities of escaping poverty in a great metropolitan region of Brazil.

Burocracia e inserção social: uma proposta para entender a gestão das organizações públicas no Brasil

This article examines the management of public organizations in Brazil, taking into account both the institutional approach and that of the economic sociology. It is a fact that the management of these organizations is affected by the actions of interest groups, especially in Brazil, which is characterized by patrimonial practices, among other things. This context forces those who work in the public sphere to constantly face the dilemma of collective action, summarized in the following question: Under such conditions, is it possible for the public organizations to act in the collective interest? To answer this question, which is related to the structure-agency debate, this work suggests two responses: One that emphasizes the agency, rationality and the formation of preferences; and another, structural, based on bureaucratic insulation and social inclusion. After such considerations, and for the purpose of illustrating the relevance of the two responses, the article discusses the case of the Bolsa Familia program (family grant), highlighting the contribution of Caixa Economica Federal and the Municipalities for the success of the program. In the end, the authors present their conclusions and recommendations for future studies.

Sistemas produtivos tradicionais e imersão de interesses econômicos em relações sociais

The municipality of Resende Costa (MG) has had a tradition of domestic textile production since the 18th century. However, since the end of the 20th century it has been a market of traditional weaving. This article analyzes the social construction of this municipal market based on records from the 18th and 19th centuries, research from late 20th century and also preliminary data gathered in 2009 from 664 domestic producers and 69 businesses. This market was made up of uneven production in the homes, the division of labor, and the commercial bureaucratic organization which controls their production services to meet consumer demands and solidarity among individuals with economic interests immersed in family relationships, which make up the density and moral discipline of this municipal market of traditional weaving.

Urban bias in development and educational attainment in Brazil

The main goal of this study is to investigate the role of the urban bias in the Brazilian development on the educational attainment process. Theories of educational inequality and socioeconomic development and modernization are considered to construct the hypotheses. The study is based on a nation-wide probability sample survey (the 1988 PNAD). OLS regression models are estimated to assess the hypotheses, and a cohort strategy is used to investigate trends in the patterns of determinants of the educational attainment process in Brazil. Among the main causal factors analyzed here, we center our investigation on the importance of the difference of having an urban or a rural origin on the educational attainment of individuals. The process of socioeconomic development in most developing countries has been marked by a very strong urban bias. As we show here, this urban bias has a very significant effect (net of many other causal variables) on the educational attainment process in Brazil.

Curso da vida e capacidade para o trabalho entre adultos mais velhos: ELSI-Brasil

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.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.

Posição socioeconômica e deficiência: “Estudo Saúde em Belo Horizonte, Brasil”

This study aims to investigate the association of socioeconomic status and comorbidities of self-reported disability. Data were obtained from a population survey in Belo Horizonte from 2008 to 2009. The sample was probabilistic and stratified by conglomerates in three stages: census tracts, households and individuals. The outcome variable was disability, defined by the self-reported problems in bodily functions or structures. The explanatory variables were gender, age, self-reported morbidity and socioeconomic status index that included variables mother and respondent schooling and household income. The factorial analysis was used to evaluate the socioeconomic status index and logistic regression. The prevalence of disability was 10.43% (95% CI: 9.1-11.7%). Self-reported disability was associated with age (OR = 1.02; 95% CI: 1.01-1.03) and reporting of two or more diseases (OR = 3.24; CI 95%; 2.16-4.86) and socioeconomic status index (OR = 0.96; 95% CI: 0.95-0.97). The worse socioeconomic status and occurrence of diseases appear to contribute to the occurrence of disability. These results show health inequities among people with disabilities, and BPC relevance supporting vulnerable populations.

Insulamento burocrático, inserção social e políticas públicas no Brasil: o caso do CrediAmigo

O artigo analisa a proposta metodologica do CrediAmigo, programa de Microcredito do Banco do Nordeste (BNB). Visamos identificar os fatores organizacionais que tornam viavel a proposta do ponto de vista financeiro e social. O trabalho utiliza dois tipos de dados: secundarios, sobre os montantes e inadimplencia da operacao (fornecidos pelo BNB), e primarios, fruto de observacao participativa do processo de operacao, aplicacao da metodologia e percepcoes dos proprios clientes. O principal achado sustenta a hipotese do insulamento burocratico e da insercao social. O BNB so consegue viabilizar a operacao apos um longo processo de aprendizado, no qual foi criado um corpo burocratico ad hoc, diferente dos funcionarios de carreira do Banco, gerenciado por uma Organizacao Nao Governamental, o Instituto Nordeste Cidadania (INEC), fundada pelo proprio BNB. A burocracia do INEC tem um perfil de formacao adaptado aos setores sociais que subsistem na economia informal. Os resultados ampliam a unilateralidade de outros estudos sobre o CrediAmigo. Do ponto de vista sociologico, concluimos que a dimensao institucional-organizativa e um fator-chave para explicar a viabilidade da operacao do microcredito. Muito alem da ideia simples de que as organizacoes so reduzem custos de transacao, as instituicoes forjam aprendizados e criam habilidades de trabalho em seus funcionarios.

Empirical analysis of the International Classification of Functioning, Disability and Health (ICF) using structural equation modeling

ABSTRACT Objective: To empirically test the relationships proposed by the International Classification of Functioning, Disability and Health (ICF) among its domains. Method: The cross-sectional study was completed with 226 adult patients with different health conditions who attended a Brazilian rehabilitation unit. The ICF components were measured with the following instruments: World Health Organization Disability Assessment Instrument II, Functional Independence Measure, Participation Scale, Craig Hospital Inventory of Environmental Factors, and a protocol designed to gather information on body structure and function and personal factors. Results: Structural equation modeling showed good model adjustment, GFI=0.863; AGFI=0.795; RMSEA=0.028 (90% CI=0.014-0.043). Significant relationships were found between activity and both body structure and function (standard coefficient=0.32; p<0.0001) and participation components (standard coefficient=–0.70; p<0.0001). Environmental and personal factors had a significant effect on the three functioning components (standard coefficient =0.39; p<0.0001; standard coefficient =-0.35; p<0.001, respectively). In contrast, body structure and function had no significant effect on participation (standard coefficient=–0.10; p=0.111) and health conditions had no significant effect on any of the functioning components, i.e., body structure and function, activity, and participation (standard coefficient=–0.12; p=0.128). Conclusion: Some of the ICF’s proposed relationships across domains were confirmed, while others were not found to be significant. Our results reinforce the contextual dependency of the functioning and disability processes, in addition to putting into perspective the impact of health conditions.

Division of social work and local productive arrangements: economic reflections of the moral effects of interorganizational networks

Este artigo utiliza um recorte teorico que evidencia fatos sociais, especificamente da divisao do trabalho social, que atuam diretamente na eficiencia de organizacoes, por meio da coesao e da solidariedade. Entretanto, essa leitura da realidade socioeconomica nao vem sendo utilizada em sua plenitude para a compreensao da imersao social de redes interorganizacionais territorializadas, ou seja, de arranjos produtivos locais. Pode-se perceber que uma das principais caracteristicas competitivas, denominadas atuais dentro do discurso empresarial e ate mesmo de politicas de desenvolvimento economico, e a necessidade de as empresas atuarem de forma conjunta e associada em determinados territorios, sejam estes distritos industriais, regioes, municipios ou cidades. Portanto, a aglomeracao e uma possibilidade concreta para o desenvolvimento empresarial a partir de estruturas organizacionais baseadas na associacao, complementariedade, compartilhamento, troca e ajuda mutua, que tem como referencia as redes, que tambem compoem a estrutura social de mercados e reforcam a discussao sociologica de que a competicao tambem gera a solidariedade. As acoes economicas individuais nao estao livres de pressoes estruturais e suscetiveis de ser interpretadas dentro da logica puramente aditiva e mecânica da agregacao. As pressoes estruturais que pesam sobre a acao economica nao se reduzem as necessidades inscritas, em dado momento do tempo, nas disponibilidades economicas imediatas ou na instabilidade das interacoes. Os interesses economicos de mercado estao, para a nova sociologia, economica imersos em redes pessoais e de grupos sociais. O mercado, portanto, nao se constitui de organizacoes isoladas, como nos modelos de concorrencia perfeita da ciencia economica, mas de aglomerados organizacionais que formam uma estrutura social.