Jurema Corrêa da Mota

Health inequalities in Rio de Janeiro, Brazil: lower healthy life expectancy in socioeconomically disadvantaged areas.

OBJECTIVES We investigated deprivation and inequalities in life expectancy and healthy life expectancy by location in Rio de Janeiro, Brazil. METHODS We conducted a health survey of 576 adults in 2006. Census tracts were stratified by income level and categorization as a slum. We determined health status by degree of functional limitation, according to the approach proposed by the World Health Organization. We calculated healthy life expectancies by Sullivans method with abridged life table. RESULTS We found the worst indicators in the slum stratum. The life expectancy at birth of men living in the richest parts of the city was 12.8 years longer than that of men living in deprived areas. For both men and women older than age 65 years, healthy life expectancy was more than twice as high in the richest sector as in the slum sector. CONCLUSIONS Our analysis detailed the excess burden of poor health experienced by disadvantaged populations of Rio de Janeiro. Policy efforts are needed to reduce social inequalities in health in this city, especially among the elderly.

Análise de correspondência como estratégia para descrição do perfil da mulher vítima do parceiro atendida em serviço especializado

Domestic violence perpetrated against women by their live-in partners may be rated as a public health problem. Knowledge of battered womens profiles helps shape specific actions that curtail this type of aggression. This paper examines the links between violence groups, and the socio-demographic status of aggressors and their victims, using the Multiple Correspondence analysis technique in order to profile the women helped by the Integrated Womens Assistance Center (CIAM). The findings showed different profiles for women assaulted by their partners in terms of the severity of the violence. Victims with severe sexually-related injuries were associated with incomplete high school educations and more than three workers resident in the home. Victims with serious physical and psychological injuries were related to university educations and graduate studies, declared as heads of families. Victims with minor physical and psychological injuries were related to relationships lasting less than five years, with high school diplomas for the women and younger aggressors, employed, and with up to three workers resident in the home.

Comparison between two race/skin color classifications in relation to health-related outcomes in Brazil

BackgroundThis paper aims to compare the classification of race/skin color based on the discrete categories used by the Demographic Census of the Brazilian Institute of Geography and Statistics (IBGE) and a skin color scale with values ranging from 1 (lighter skin) to 10 (darker skin), examining whether choosing one alternative or the other can influence measures of self-evaluation of health status, health care service utilization and discrimination in the health services.MethodsThis is a cross-sectional study based on data from the World Health Survey carried out in Brazil in 2003 with a sample of 5000 individuals older than 18 years. Similarities between the two classifications were evaluated by means of correspondence analysis. The effect of the two classifications on health outcomes was tested through logistic regression models for each sex, using age, educational level and ownership of consumer goods as covariables.ResultsBoth measures of race/skin color represent the same race/skin color construct. The results show a tendency among Brazilians to classify their skin color in shades closer to the center of the color gradient. Women tend to classify their race/skin color as a little lighter than men in the skin color scale, an effect not observed when IBGE categories are used. With regard to health and health care utilization, race/skin color was not relevant in explaining any of them, regardless of the race/skin color classification. Lack of money and social class were the most prevalent reasons for discrimination in healthcare reported in the survey, suggesting that in Brazil the discussion about discrimination in the health care must not be restricted to racial discrimination and should also consider class-based discrimination. The study shows that the differences of the two classifications of race/skin color are small. However, the interval scale measure appeared to increase the freedom of choice of the respondent.

Correspondence analysis: a method for classifying similar patterns of violence against women

Violence against women has received relatively little debate in society. It includes physical, psychological, and sexual abuse that jeopardizes the victims health. Multivariate correspondence analysis and cluster analysis were applied to crimes reported to the Integrated Womens Aid Center in Rio de Janeiro, Brazil, to investigate associations between injury and define criteria for classifying the aggressions. Three groups of abuse were identified, differing according to the nature (physical, psychological, or sexual) and severity of the crimes. Less serious crimes consisted of threats and moderate physical injuries. The intermediate severity group included serious physical assault and threats. More serious crimes included death threats, rape, and sexual assault. The method thus allowed classification of the crimes in three groups according to severity.

Carga de doença no Brasil e suas regiões, 2008

The current study estimated DALY (disability-adjusted life years), an indicator of burden of disease, for Brazil in 2008. The North and Northeast regions showed higher burden of disease. Chronic noncommunicable diseases predominated in all regions of the country, especially cardiovascular diseases, mental disorders (particularly depression), diabetes, and chronic obstructive pulmonary disease. The study also showed a high burden of homicides and traffic accidents. Brazils epidemiological profile appears even more complex when one considers the non-negligible burden of communicable diseases, maternal and perinatal conditions, and nutritional deficiencies. The analyses allowed a more detailed understanding of the Brazilians populations health status, underscoring the need for crosscutting actions beyond specific health sector policies and greater attention to the quality of information on morbidity and mortality.En este estudio, se estimo DALY (anos de vida ajustados por discapacidad), un indicador de estudios de carga de enfermedad, para Brasil durante 2008. Entre los principales resultados se observan la mayor carga de enfermedad en las regiones Norte y Noreste y la preponderancia de las enfermedades cronicas no transmisibles en todas las regiones del pais; en particular, las enfermedades cardiovasculares, los trastornos mentales, destacandose la depresion, la diabetes y la enfermedad pulmonar obstructiva cronica. Llama tambien la atencion la elevada carga de homicidios y accidentes de trafico. El perfil epidemiologico se revela mas complejo cuando se considera la no despreciable carga de enfermedades transmisibles, condiciones maternas, perinatales y deficiencias nutricionales. Los analisis efectuados hicieron posible conocer el status de salud de la poblacion, lo que pone en evidencia la demanda de acciones que van mas alla de politicas especificas para el area de la salud, asi como la necesidad de ampliar la preocupacion con la calidad de las informaciones sobre morbimortalidad en Brasil.

Burden of disease in Brazil and its regions, 2008

The current study estimated DALY (disability-adjusted life years), an indicator of burden of disease, for Brazil in 2008. The North and Northeast regions showed higher burden of disease. Chronic noncommunicable diseases predominated in all regions of the country, especially cardiovascular diseases, mental disorders (particularly depression), diabetes, and chronic obstructive pulmonary disease. The study also showed a high burden of homicides and traffic accidents. Brazils epidemiological profile appears even more complex when one considers the non-negligible burden of communicable diseases, maternal and perinatal conditions, and nutritional deficiencies. The analyses allowed a more detailed understanding of the Brazilians populations health status, underscoring the need for crosscutting actions beyond specific health sector policies and greater attention to the quality of information on morbidity and mortality.En este estudio, se estimo DALY (anos de vida ajustados por discapacidad), un indicador de estudios de carga de enfermedad, para Brasil durante 2008. Entre los principales resultados se observan la mayor carga de enfermedad en las regiones Norte y Noreste y la preponderancia de las enfermedades cronicas no transmisibles en todas las regiones del pais; en particular, las enfermedades cardiovasculares, los trastornos mentales, destacandose la depresion, la diabetes y la enfermedad pulmonar obstructiva cronica. Llama tambien la atencion la elevada carga de homicidios y accidentes de trafico. El perfil epidemiologico se revela mas complejo cuando se considera la no despreciable carga de enfermedades transmisibles, condiciones maternas, perinatales y deficiencias nutricionales. Los analisis efectuados hicieron posible conocer el status de salud de la poblacion, lo que pone en evidencia la demanda de acciones que van mas alla de politicas especificas para el area de la salud, asi como la necesidad de ampliar la preocupacion con la calidad de las informaciones sobre morbimortalidad en Brasil.

Medidas de estimación de la estatura aplicadas al índice de masa corporal (IMC) en la evaluación del estado nutricional de adultos mayores

Introduccion: En el adulto mayor la antropometria es parte de un conjunto de herramientas para la evaluacion nutricional, sin embargo la estatura se modifica con el envejecimiento, lo que puede alterar la interpretacion de los resultados. Objetivo: Analizarlas medidas de estimacion de la estatura aplicadas al indice de Masa Corporal (IMC) para la evaluacion nutricional de adultos mayores. Metodo: Estudio transversal con 344 adultos mayores de la Municipalidad de Rio de Janeiro. Se midio el peso (P), la estatura (E), la media-envergadura de brazo (MEB) y la altura de rodilla (AR) y se calculo indice de Masa Corporal(IMC) para: IMC1(Peso/Talla2), IMC2[P/ (MEBx2)2] e IMC3[P/(ecuacion de altura de rodilla)2]. En la comparacion de los promedios se utilizo el test t de Student para muestras independientes y las diferencias y concordancia entre IMCs fueron analizados con test X2 y el Coeficiente Kappa ponderado, respectivamente. Resultados: El promedio de IMC! fue 24,7 kg/m2 ±5,6, IMC2 23,3 kg/m2 ±6,1 e IMC3 24,7 kg/m2 ±5,6. El Kappa ponderado entre IMC1 e IMC3 fue 0,78 y entre IMC1 e IMC2 0,61. Conclusiones: El IMC basado en la altura de rodilla presento una fuerte asociacion con el IMC basado en la estatura medida directamente, seguido del IMC en que fue usada la media-envergadura de brazo. La altura de rodilla seria la medida mas proxima al valor real de la estatura.

Estudo da carga de doença das condições orais em Minas Gerais, Brasil, 2004-2006

Os agravos orais sao um problema de saude publica devido a sua prevalencia em praticamente todos os grupos etarios. Estudo da Carga Global de Doenca para carie dentaria, edentulismo e doenca periodontal. Utilizou-se o DALY, que mede simultaneamente o impacto da mortalidade e dos problemas de saude que afetam a qualidade de vida. A Carga de Doenca para condicoes orais foi analisada em numeros absolutos e taxas/1.000 habitantes. O numero de YLD para carie foi de 4.489. Estimou-se 33.888 YLD para edentulismo, com taxa de 2,2/1.000 nas mulheres. Na doenca periodontal estimou-se 3.217 YLD, resultando em uma taxa de 0,2/1.000 para ambos os sexos. O edentulismo contribuiu mais para a carga de doenca orais, sendo mais frequente nas mulheres. Maiores taxas de edentulismo e doenca periodontal foram de 45-69 anos, enquanto carie de 15-49 anos. Os estudos de Carga Global de Doenca representam um importante aspecto do diagnostico de saude, integrando desfechos fatais e nao fatais. Alem disso, disponibiliza informacoes de grande relevância na formulacao de politicas de prevencao e tratamento.

Descrição dos registros repetidos no Sistema de Informação de Agravos de Notificação, Brasil, 2008-2009

OBJECTIVE to describe the proportion of duplicate records held on the Brazilian Notifiable Diseases Information System, 2008-2009. METHODS identification of duplicate records of dengue, leprosy, visceral leishmaniasis and cutaneous leishmaniasis, meningitis and tuberculosis was conducted using Reclink III(r); the proportion of duplicate records was calculated by geographical region, state and municipal population size categories. RESULTS visceral leishmaniasis (VL) and meningitis had higher proportions of duplicate notification (5.3% and 3.6%, respectively) whilst leprosy had the lowest (0.7%); the states with highest repetitions were Rio Grande do Norte (VL 6.8% and leprosy 5.1%), Rio de Janeiro (tuberculosis 2.5% and meningitis 4.9%) and Goiás (dengue 2.0% and meningitis 7.2%). CONCLUSION the Northeast region had the highest proportion of duplicate records for four of the six diseases analyzed; with the exception of dengue, percentage repetition was lower in municipalities with larger population size.OBJETIVO: descrever a proporcao de registros repetidos no Sistema de Informacao de Agravos de Notificacao do Brasil, em 2008 e 2009. METODOS: para identificacao de registros repetidos de casos de dengue, hanseniase, leishmaniose visceral (LV) e leishmaniose tegumentar americana (LTA), meningites e tuberculose, utilizou-se o aplicativo Reclink III(r); calculou-se a proporcao dos registros repetidos segundo macrorregioes, Unidades da Federacao e categorias de porte populacional do municipio. RESULTADOS: LV e meningites apresentaram maiores proporcoes de registros repetidos (5,3% e 3,6%, respectivamente) e hanseniase a menor (0,7%); proporcoes mais elevadas foram observadas no Rio Grande do Norte (6,8% para LV; 5,1% para hanseniase), Rio de Janeiro (2,5% para tuberculose; 4,9% para meningites) e Goias (2,0% para dengue; 7,2% para meningites). CONCLUSAO: a macrorregiao Nordeste concentrou maior proporcao de registros repetidos para quatro das seis doencas estudadas; a excecao da dengue, o percentual de repeticao foi menor nos municipios mais populosos.

A evolução da carga de causas externas no Brasil: uma comparação entre os anos de 1998 e 2008

The objective of this study was to compare estimates of external causes based on the Global Burden of Disease in Brazil Study for the years 1998 and 2008. Methods included estimation of DALYs (disability-adjusted life years) and YLL (years of life lost), based on the methodology proposed in the Global Burden of Disease Study. Calculation of YLD (years lived with disability) required applying the same methodology in both years, with the 2008 methodology as the standard. Although external causes accounted for some 10% of total DALYs in both years, their internal distribution showed marked differences between regions of Brazil, with a decrease in the Southeast and increase in the North and Northeast. There was an increase in intentional causes, and YLLs accounted for the largest share of DALYs. The results can support new policies and/or improve existing ones to address external causes.The objective of this study was to compare estimates of external causes based on the Global Burden of Disease in Brazil Study for the years 1998 and 2008. Methods included estimation of DALYs (disability-adjusted life years) and YLL (years of life lost), based on the methodology proposed in the Global Burden of Disease Study. Calculation of YLD (years lived with disability) required applying the same methodology in both years, with the 2008 methodology as the standard. Although external causes accounted for some 10% of total DALYs in both years, their internal distribution showed marked differences between regions of Brazil, with a decrease in the Southeast and increase in the North and Northeast. There was an increase in intentional causes, and YLLs accounted for the largest share of DALYs. The results can support new policies and/or improve existing ones to address external causes.