Lúcia Rolim Santana de Freitas

Evolução da prevalência do diabetes e deste associado à hipertensão arterial no Brasil: análise da Pesquisa Nacional por Amostra de Domicílios, 1998, 2003 e 2008

Objective: to estimate the prevalence of diabetes, and associated hypertension for Brazilian states and Federal District, in 2008, and describe its temporal trends according to sociodemographic variables and its distribution in Brazil and regions, in 1998, 2003 and 2008. Methods: cross-sectional study with microdata from the National Household Sample Survey in the selected years; crude and age-and-sex standardized prevalence rates were calculated for the entire population and for subgroups of the sociodemographic variables. Results: in Brazil, the standardized prevalence rate of diabetes increased from 2.9% in 1998 to 4.3% in 2008; for diabetes associated to hypertension, this ratio rose from 1.7% to 2.8% over the same period. These increases were statistically significant for Brazil, as well as for all rates and categories of the studied variables. Conclusion: the prevalence of diabetes and associated hypertersion is growing rapidly in Brazil.

Leprosy in Brazil and its association with characteristics of municipalities: ecological study, 2009-2011.

To analyse the ecological association between the demographic and socio‐economic characteristics of the Brazilian municipalities and average leprosy incidence rate in the period 2009–2011.OBJECTIVE To analyse the ecological association between the demographic and socio-economic characteristics of the Brazilian municipalities and average leprosy incidence rate in the period 2009-2011. METHODS An ecological study taking the Brazilian municipalities as its units of analysis. The local empirical Bayes estimation method was used to obtain smoothed incidence rates (SIR) for leprosy. The mean, median, first quartile (Q1) and third quartile (Q3) of the SIR were calculated per 100 000 inhabitants. Hierarchical log-linear negative binomial regression models were used to estimate the incidence rate ratios (IRR). RESULTS In the period 2009-2011, the average SIR of leprosy in Brazil was 20.2 per 100 000 inhabitants, and the median incidence rate among municipalities was 9.1 per 100 000 inhabitants. Significantly higher adjusted IRR were identified for large municipalities (IRR = 1.67) compared to small municipalities, as well as in municipalities with higher illiteracy rates (IRR = 2.15), more urbanised municipalities (IRR = 1.53), those with greater social inequality as per the Gini index (IRR = 1.26), high percentage of households with inadequate sanitation (IRR = 1.63), higher average number of people per room (IRR = 1.41), high proportions of Family Health Programme coverage (IRR = 1.29), high percentage of household contacts investigated (IRR = 2.30) and those with percentage of cases with grade 2 disability considered to be the medium (IRR = 1.26). CONCLUSIONS In this study, SIR was significantly associated with municipalities with low socio-economic status. Disease control activities need to be focused on these municipalities, and investments need to be made in improving the populations living conditions.

Gastos das famílias brasileiras com medicamentos segundo a renda familiar: análise da Pesquisa de Orçamentos Familiares de 2002-2003 e de 2008-2009

This study aimed to investigate spending on medicines by Brazilian families and related income inequalities, according to types of medicines. A cross-sectional study used data from the Family Budget Surveys conducted in 2002-2003 and 2008-2009. Expenditures were corrected according to the Extended National Consumer Price Index (IPCA). The Concentration Index (CI) was calculated as a measure of inequality. Average monthly spending on medicines was BRL 53.54 in the 2002-2003 survey and BRL 59.02 in 2008-2009. CI showed spending concentration in higher-income families. Spending composition varied according to family income. Lower-income families spent predominantly on analgesics, cold medicines, and anti-inflammatory drugs. Higher-income families concentrated their spending on medicines for diabetes and hypertension (and other cardiovascular diseases). From one survey to the next, even though lower-income households reduced the percentage of their budget spent on medicines, the latter still consume a large proportion of their health spending.O estudo teve como objetivos investigar os gastos das familias brasileiras com medicamentos e as desigualdades de renda nestes gastos, segundo categorias de medicamentos. Trata-se de estudo transversal realizado com dados das Pesquisas de Orcamentos Familiares (POF) realizadas em 2002-2003 e 2008-2009. Os valores foram corrigidos pelo Indice Nacional de Precos ao Consumidor Amplo (IPCA). O Indice de Concentracao (IC) foi calculado como medida de desigualdade. O gasto medio com medicamentos para o total das familias correspondeu a R

Associação ecológica entre características dos municípios e o risco de homicídios em homens adultos de 20-39 anos de idade no Brasil, 1999-2010

53,54 na POF 20022003 e R

Avaliação preliminar do impacto da Lei da Cadeirinha sobre os óbitos por acidentes de automóveis em menores de dez anos de idade, no Brasil: estudo de séries temporais no período de 2005 a 2011

59,02 na POF 2008-2009. Os IC revelaram concentracao dos gastos entre as familias de maior renda. A composicao destes gastos e diferente conforme a renda das familias. Entre as de menor renda predominam os gastos com analgesicos, antigripais e anti-inflamatorios. Entre as de maior renda predominam os gastos com medicamentos para diabetes, hipertensao e doencas do coracao. Para as familias de menor renda, apesar da reducao do peso do gasto com medicamentos sobre sua renda, este ainda e o principal componente dos gastos com saude.

Gastos com planos de saúde das famílias brasileiras: estudo descritivo com dados das Pesquisas de Orçamentos Familiares 2002-2003 e 2008-2009

Homicide mortality remains a major public health problem in Brazil, especially among young adult males. The aim of this study was to assess the homicide mortality risk (HMR) among males aged 20 to 39, and its association with selected socio-demographic characteristics of the Brazilian municipalities. This is an ecologic study in which all the municipalities in Brazil were the unit of analysis. Time trends (from 1999-2002) and adjusted associations between HMR and socio-demographic characteristics of municipalities were estimated in a cross-sectional analysis for 2007-2010 in this study. Between 1999-2002 and 2007-2010, an increasing trend of mean HMR rates from 22.7 to 35.5 per 100,000 inhabitants was observed in Brazil. In 2007-2010, HMR rates were significantly higher (p<0.001) in the largest cities, with higher fertility rates, lower literacy rates, higher social inequality (as estimated by the 20/40 income ratio) and more-urbanized municipalities. Considering the proportion of low income population and the average per capita income, associations with HMR identified greater risks in the intermediary categories of these independent variables. Findings from this study may support the implementation of focal policies directed to more vulnerable municipalities.

Consumo abusivo de álcool no Brasil: resultados da Pesquisa Nacional de Saúde 2013

Objective: to evaluate the preliminary impact of a child restraint law on the occurrence of deaths caused by car accidents among under ten years old, in Brazil. Methods: a time series study with before and after design data from the Mortality Information System during the period from September 2005 to August 2011; the Seasonal Auto-Regressive Integrated Moving Average (SARIMA) model was used. Results: within one year after the enactment of the law, 227 deaths were recorded, while in the previous year, 296 were recorded; the annual average for the previous five years was 267.8; after the enactment of the law, there was a 23.0% negative variation in the absolute number of deaths,with no statistical significance. Conclusion: despite the reduction in the absolute number of deaths, a statistically significant impact of the law was not observed, possibly due to the short post-intervention observation period.

Heavy drinking in Brazil: results from the 2013 National Health Survey

Spending on health insurance represents an important share of private expenditure on health in Brazil. The study aimed to describe the evolution of spending on private health insurance plans of Brazilian families, according to their income. Data from the Family Budget Surveys (POF) 2002-2003 and 2008-2009 were used. To compare the spending figures among the surveys, the Consumer Price Index (IPCA) was applied. The proportion of families with private health insurance expenses remained stable in both surveys (2002-2003 and 2008-2009), around 24%. However, the household spending on health insurance plans increased. Among those families who spent money oh health insurance plans, the average spending increased from R

Deaths of bicycle riders in Brazil: characteristics and trends during the period of 2000 - 2010

154.35 to R

Brazilian family spending on medicines: an analysis of data from the Family Budget Surveys, 2002-2003 and 2008-2009

183.97. The average spending on health insurance plans was greater with increasing household income, as well as portions of the family income and total expenditure committed to these expenses. Spending on health insurance is concentrated among higher-income families, for which it was the main component of total health expenditure.Spending on health insurance represents an important share of private expenditure on health in Brazil. The study aimed to describe the evolution of spending on private health insurance plans of Brazilian families, according to their income. Data from the Family Budget Surveys (POF) 2002-2003 and 2008-2009 were used. To compare the spending figures among the surveys, the Consumer Price Index (IPCA) was applied. The proportion of families with private health insurance expenses remained stable in both surveys (2002-2003 and 2008-2009), around 24%. However, the household spending on health insurance plans increased. Among those families who spent money oh health insurance plans, the average spending increased from R