Moisés Goldbaum

Hipertensão arterial em idosos: prevalência, fatores associados e práticas de controle no Município de Campinas, São Paulo, Brasil

The objective of this study was to assess the prevalence of reported hypertension among the elderly in Campinas, Sao Paulo, Brazil, identifying related factors, the use of healthcare services, and knowledge and practices related to treatment options. This was a cross-sectional population-based study, with stratified clustered multiple-stage sampling. Data analysis for the 426 individuals (60 years of age and older) considered the sampling design and outlining effect. Hypertension prevalence was 51.8% (46.4% in men and 55.9% in women) and was higher among the elderly with less education (55.9%), immigrants from other States (60.2%), and the overweight or obese (57.2%). The results indicate that healthcare services are ensuring access to medical care (71.6% have regular physician appointments) and medication (86.7% take their routine medication), without distinction as to socioeconomic status. However, social inequalities persist in knowledge and use of other measures to control blood pressure, like appropriate diet and exercise, which are also underused by more privileged socioeconomic strata.

Práticas preventivas de detecção de câncer em mulheres: comparação das estimativas dos inquéritos de saúde (ISA - Capital) e vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico (VIGITEL - São Paulo)

OBJETIVO: O objetivo deste estudo foi comparar estimativas obtidas em inqueritos domiciliar e telefonico, da realizacao dos exames de Papanicolaou e mamografia em mulheres residentes no municipio de Sao Paulo em 2008, segundo caracteristicas sociodemograficas, bem como dimensionar as diferencas observadas. METODOS: Foram utilizados os dados do ISA - Capital 2008, inquerito domiciliar realizado no municipio de Sao Paulo pela Universidade de Sao Paulo (USP), Universidade Estadual de Campinas (UNICAMP) e Secretaria de Estado da Saude com apoio da Secretaria Municipal de Saude de Sao Paulo, e do VIGITEL - Sao Paulo, inquerito telefonico realizado pelo Ministerio da Saude para Vigilância de Fatores de Risco e Protecao para Doencas Cronicas. Estimativas da realizacao do exame de Papanicolaou e mamografia na vida, bem como a realizacao no ultimo ano foram comparadas segundo o tipo de inquerito (domiciliar/telefone) por meio de regressao de Poisson ajustada por idade e escolaridade. RESULTADOS: Nao foram encontradas diferencas estatisticamente significantes entre as estimativas obtidas pelo VIGITEL e ISA - Capital para as prevalencias de realizacao de mamografia no ultimo ano. No entanto, para as estimativas globais de realizacao do exame de Papanicolaou alguma vez na vida e no ultimo ano e da mamografia na vida, foi possivel verificar diferencas estatisticamente significantes, com prevalencias de cobertura superiores entre as entrevistadas pelo inquerito telefonico. CONCLUSAO: Os resultados sinalizam a tendencia de superestimacao de alguns indicadores de cobertura de mamografia e de exame de Papanicolaou nos dados de pesquisa via telefone, apontando a necessidade de novos estudos que tambem contribuam para o melhor entendimento das diferencas observadas com o uso de diferentes modalidades de inqueritos.

Diabetes mellitus: fatores associados à prevalência em idosos, medidas e práticas de controle e uso dos serviços de saúde em São Paulo, Brasil

This study analyzes factors associated with diabetes prevalence according to demographic and socioeconomic variables, health status, and lifestyle among 872 elderly living in the city of São Paulo, Brazil, in addition to health services utilization and control measures and practices. Reported diabetes prevalence among the elderly was 17.9%, a higher rate than in the adult population. The highest diabetes rates in elderly individuals were associated with: bad or very bad self-rated health, never having consumed alcohol or having stopped drinking, widowhood, and at least one hospitalization in the previous 12 months, independently of age. Among the elderly, 69.9% routinely sought out health services due to their diabetes, and 96.1% received treatment at the services they turned to. There is a lack of information, knowledge, and use of control measures for diabetes among the elderly. Health policies focusing on professional training and family orientation are needed to promote lifestyle changes among the elderly.This study analyzes factors associated with diabetes prevalence according to demographic and socioeconomic variables, health status, and lifestyle among 872 elderly living in the city of Sao Paulo, Brazil, in addition to health services utilization and control measures and practices. Reported diabetes prevalence among the elderly was 17.9%, a higher rate than in the adult population. The highest diabetes rates in elderly individuals were associated with: bad or very bad self-rated health, never having consumed alcohol or having stopped drinking, widowhood, and at least one hospitalization in the previous 12 months, independently of age. Among the elderly, 69.9% routinely sought out health services due to their diabetes, and 96.1% received treatment at the services they turned to. There is a lack of information, knowledge, and use of control measures for diabetes among the elderly. Health policies focusing on professional training and family orientation are needed to promote lifestyle changes among the elderly.

Qualidade da dieta de adolescentes: estudo de base populacional em Campinas, SP

We assessed the overall diet quality and adequacy of diet consumption of each component of the diet of adolescents according to demographic, socioeconomic and body mass index (BMI) data. A cross-sectional population-based study analyzed a representative sample of 409 adolescents, aged 12-19 years, using the Healthy Eating Index (HEI). We estimated the prevalence of diets classified in the first quartile of the HEI and the average scores of each component of the HEI. Linear and Poisson multiple regressions were used in the analysis. The mean score of HEI was 59.7. We observed a lower prevalence of inadequate diets in the segment with heads of household presenting higher schooling. The lower socioeconomic status segments, measured by income and schooling, showed a lower consumption of vegetables, fruits, dairy products and a less diversified diet, and a higher intake of cereals and legumes. Overweight/obese adolescents consume more meat and eggs and less fruit compared to low weight/normal weight adolescents. Girls had a higher intake of total fat and lower sodium intake. The results identified diet components that deserve more attention in the strategies to promote healthy eating, and the more vulnerable segments among adolescents.We assessed the overall diet quality and adequacy of diet consumption of each component of the diet of adolescents according to demographic, socioeconomic and body mass index (BMI) data. A cross-sectional population-based study analyzed a representative sample of 409 adolescents, aged 12-19 years, using the Healthy Eating Index (HEI). We estimated the prevalence of diets classified in the first quartile of the HEI and the average scores of each component of the HEI. Linear and Poisson multiple regressions were used in the analysis. The mean score of HEI was 59.7. We observed a lower prevalence of inadequate diets in the segment with heads of household presenting higher schooling. The lower socioeconomic status segments, measured by income and schooling, showed a lower consumption of vegetables, fruits, dairy products and a less diversified diet, and a higher intake of cereals and legumes. Overweight/obese adolescents consume more meat and eggs and less fruit compared to low weight/normal weight adolescents. Girls had a higher intake of total fat and lower sodium intake. The results identified diet components that deserve more attention in the strategies to promote healthy eating, and the more vulnerable segments among adolescents.

Fatores associados à realização dos exames de rastreamento para o câncer de próstata: um estudo de base populacional

O objetivo deste estudo foi analisar a prevalencia da realizacao dos exames de rastreamento para o câncer de prostata em homens com 50 anos ou mais de idade, segundo variaveis socioeconomicas, demograficas, de comportamentos relacionados a saude e presenca de morbidade. O estudo foi do tipo transversal, de base populacional, e as analises estatisticas consideraram o delineamento da amostra. Os fatores associados a nao realizacao dos exames de rastreamento do câncer de prostata, foram: ter de idade menor que 70 anos, ter escolaridade de ate 8 anos, renda familiar per capita menor que 0,5 salario minimo, nao ter diabetes, ter limitacao visual e nao ter ido ao dentista no ultimo ano. O SUS foi responsavel pela realizacao de 41% dos exames de rastreamento do câncer de prostata referidos. Este estudo apontou que apesar da controversia sobre e efetividade do toque retal e da dosagem do Antigeno Especifico Prostatico (PSA) para a deteccao do câncer de prostata, parcela significativa da populacao masculina vem realizando estes exames para os quais existem significativas desigualdades socioeconomicas quanto ao acesso.

P1-328 Comparison of preventive practices among women in SÃo Paulo/Brazil

The aim of this study was to compare estimates of Pap smear screening and mammogram obtained from household survey and a telephone survey in São Paulo/Brazil in the year 2008, according to sociodemographic characteristics, and to dimension the observed differences from those estimates. The study used data from the ISA-Capital 2008 Survey, conducted in São Paulo city, by Faculty of Public Health of the University of São Paulo with support from the Municipal Health Department, and VIGITEL (São Paulo), a telephone survey conducted by the Brazilian Ministry of Health towards Surveillance of Risk and Protection Factors for Chronic non-transmittable Diseases. Estimates of Pap smear and mammogram in women, as well as its realisation in the year prior to the interview were compared according to type of survey (household/telephone) by Poisson regression adjusted for age and education. There were no statistically significant differences between the estimates obtained by VIGITEL and ISA-Capital for the prevalence of mammogram in the year prior to the interview. However, estimates for the global estimates of the Pap smear at least once in life and in the last year and mammogram at least once in life, there has been observed statistically significant differences, with higher prevalence among those interviewed by telephone. It shows a tendency to overestimate the prevalence of mammography and Pap smear in the telephone survey data indicating a necessity for new studies that also contribute to a better understanding of the differences observed using different types of surveys.

P1-275 Hearing health in elderly: a population-based study in SÃo paulo city, Brazil

Introduction Hearing loss in older people is one of the most prevalent chronic conditions. In 2004, was implemented in Brazil the Hearing Health Attention National Policies. This policy contains programs for prevention, diagnostic and rehabilitation, including donations of hearing aids and providing education about hearing health. Methods Data are from the Survey of Health of São Paulo (ISA-Capital, 2008), a population-based cross-sectional study (n=3271). This survey utilised the same methodology the previous surveys conducted at 2001 and 2003. We analysed the subgroup of elderly (60 years and above—n=924). We used the χ2 test of association and analysis of Poisson regression (significance level: 0.05). Results The prevalence of self-reported hearing loss in elderly in this study was 12.4%. This prevalence was higher in men than women (RP: 1.5; p=0.01) and in higher ages (more 80 years) than in 60–69 years (RP: 2.2; p=0.00). 24,4% of them did not know the cause of hearing loss and 42% related that old age is cause of this deficit. 38.8% of interviewed said that they do not need medical assistance or treatment rehabilitation. Conclusion The unknowledge of the elderly about the causes of hearing loss and the need to assistance suggests that the governments policies needs to evaluate and improve the process of assisting in these people with hearing impairment, assuring its effectiveness. Since ageing is getting wide, developing countries like Brazil, need to meet new demand from this segment of the population.

P2-234 Self-reported hearing loss and use of health services for elderly: a population based study in São Paulo city, Brazil

Introduction Hearing loss has been identified as one of the most frequent chronic conditions affecting elderly people and can be result in social isolation, depression and increased dependency. The use of health services to preventive ends it is important to evaluate the health behaviours of elderly with disabilities. Methods Data are from the Survey of Health of São Paulo (ISA-Capital), a population-based cross-sectional study (n=3357). We analysed the subgroup of elderly (60 years and above - n=872) to determine the association between reported hearing loss and use of health services: immunisation against influenza in last year, participation in prevention programs: prostate cancer, breast cancer and cervical cancer. We used the χ2 test of association and analysis of Poisson regression (significance level: 0.05). Results The prevalence of hearing loss in elderly people was 11.2% and it was higher in men than women (p=0.00). 60.5% of the elderly related to take immunisation against influenza, 82.9% of the women referred to participate the program of prevention of cervical cancer and 64.1% referred to participate the breast cancer one. There was an association between self-reported hearing loss and participate in programs to prevent prostate cancer (RP: 1,8; p=0.03). Conclusion Self-reported hearing loss can be itself a revelation indicator of handicap and it is quick and inexpensive to be performed. These data should be a tool to evaluate of the use of health services and moreover they could help to plan of hearing rehabilitation services.