Navegando por Assunto "Social determinants of health"

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Acesso aberto (Open Access)
Análise espacial da mortalidade por Aids entre jovens no Pará e os impactos dos determinantes sociais de saúde
(Universidade Federal do Pará, 2022-07-15) SOUSA, Sara Melissa Lago; BOTELHO, Eliã Pinheiro; http://lattes.cnpq.br/6276864906384922; https://orcid.org/0000-0002-9682-6530; POLARO, Sandra Helena Isse; http://lattes.cnpq.br/7875594038005793; https://orcid.org/0000-0001-5026-5080
Introduction: Worldwide, AIDS control policies have led to a small decrease in the mortality rate among young people, which is only 6% among young males. For a better effectiveness of these policies, it is necessary to take into account the influence of social determinants of health (SDH) on the mortality rate in each territory. Objective: To spatially analyze the AIDS mortality rate among young people in the state of Pará and the spatial variability of the rate promoted by the DSS from 2007 to 2018. Method: Ecological study using secondary data from the Mortality Information System (SIM). All notifications of AIDS deaths in young people residing in the state of Pará between 2007 and 2018 were included in the study. The mortality rate was analyzed using spatial distribution and autocorrelation, spatial scanning, and geographically weighted regression (GWR). Results: During the study period, 1,372 AIDS deaths were reported among young people from Pará. The AIDS mortality rate showed territorial expansion. Spatial autocorrelation showed two high-high clusters in the period from 2007 to 2010, one formed by municipalities in the southeast of Pará and the other in the metropolitan region of Belém (RMB), with only the cluster of RMB remaining between 2011 and 2018. The RMB presented the highest spatial risk for AIDS mortality and the only one with the spatio-temporal risk in the period 2013-2018. The spatial variability of the AIDS mortality rate was promoted by the "homicide rate among young people", "elementary school dropout rate" and "by the number of families registered in CADÚNICO". Conclusion: This study covers the Amazonian particularities that involve AIDS mortality among young people from Pará, allowing the spatial identification of the involvement of rate variability promoted by the DSS.
Acesso aberto (Open Access)
Análise espacial e espaço-temporal dos casos de feminicídio ocorridos no estado do Pará entre 2016 e 2021
(Universidade Federal do Pará, 2023-10-27) SILVA, Ana Karoline Souza da; BOTELHO, Eliã Pinheiro; http://lattes.cnpq.br/6276864906384922; https://orcid.org/0000-0002-9682-6530; LIMA, Vera Lúcia de Azevedo; http://lattes.cnpq.br/5247917929280755; https://orcid.org/0000-0003-0094-4530
INTRODUCTION: Feminicide is a public health problem worldwide, with Brazil occupying the 5th position among the countries that kill the most. In order to combat feminicide, it is imperative to understand its association with social determinants of health, and spatial analysis is a fundamental tool for this. OBJECTIVE: To analyze the spatial and space-time scenario of the femicide rate and its relationship with the social determinants of health in the State of Pará between 2016 and 2021. METHODS: An ecological study using secondary data from the Integrated Public Security System (SISP-WEB). Gross municipal feminicide rates were analyzed using spatial distribution and autocorrelation (Gi statistic), temporal-spatial risk analysis, and geographically weighted spatial regression (GWR). RESULTS: During the study period, 339 cases of feminicide were reported in Pará. The spatial distribution of the feminicide rate during the study period showed a territorial expansion, with municipalities in the Metropolitan Region of Belém, Northeast, Southeast, and Southwest of Pará being the most affected areas. From 2016 to 2018, there was a high-high in feminicide rate (hotspot) formed by municipalities in the southeast and southwest of Pará, while between 2019 and 2021, there were two hotspots in the southeast and northeast. The spatio-temporal analysis revealed only one risk zone (RR=2.11; p<0.000) in the period from 2018 to 2020 that consisted of municipalities in the Metropolitan region of Belém, Northeast, Lower Amazonas, Southeast and Southwest of Pará. The GWR showed that the variability of the feminicide rate was associated with the DSS “youth homicide rate per 100,000 inhabitants”, “primary care coverage rate”, and “total high school pass rate”. CONCLUSION: To combat feminicide it is necessary to promote greater social equity, discuss gender equality in schools, and bring greater responsibility/qualification of health professionals in the Primary Health Care network for the early identification of signs of domestic violence as well as reporting to competent legal channels.
Acesso aberto (Open Access)
Epidemia do HIV e os determinantes sociais em saúde entre jovens no contexto amazônico: análise geograficamente ponderada e projeções temporais
(Universidade Federal do Pará, 2022-07-11) PEDROSO, Andrey Oeiras; NOGUEIRA, Laura Maria Vidal; http://lattes.cnpq.br/9020674768816530; https://orcid.org/0000-0003-0065-4509; BOTELHO, Eliã Pinheiro; http://lattes.cnpq.br/6276864906384922; https://orcid.org/0000-0002-9682-6530
Introduction: In Brazil, the HIV/AIDS detection rate (/100,000 inhab.) showed a decrease in the general population of 17.2%, from 2009 (21.5) to 2019 (17.8). However, this rate increased substantially among the young population, which had the highest detection rate in the country, 52.0 (/100,000 inhab.) (BRASIL, 2020a). This advance on the young population is due to obstructions, discrimination, inequalities, stigmas and social and health inequities, intrinsic vulnerabilities of this population stratum that enhance their chances of becoming infected with HIV. However, the risk of HIV infection cannot be conditioned only to the individual, since behaviors are directly influenced by socioeconomic territorial factors that exceed the individual. Despite all the advancement of HIV among young people, there is a scarcity of studies aimed at analyzing the impact of Social Determinants of Health (SDH) on the epidemic in this age group. Objective: To analyze temporally and spatially the HIV epidemic among young people in the State of Pará. Methods: An ecological study that analyzed HIV/AIDS cases diagnosed between 2007 and 2018 in Pará, Brazil. An exploratory analysis was performed using descriptive statistics. The temporal projections (2019-2022) used mixed method, ARIMA + STL in the RStudio software. For the spatial analysis, we used statistical scanning techniques to obtain the Relative Risk (RR), with a confidence interval of 95%; Moran's autocorrelation statistic considering statistically significant (p < 0.05) for building the LISAMap in ArcGIS software. In SPSS software, we developed models from Ordinary Least Squares (OLS) and later by Geographically Weighted Regression (GWR), with spatial analysis of residuals, with the help of MGWR and ArcGIS software. Results: Of the 8,143 cases analyzed, 47.97% were young people between 25 and 29 years old, men (66.46%), mixed race (76.95%), living in urban areas (85.20%) and heterosexuals (54 .41%). An expansion of HIV among young people in Pará was identified, with a temporal projection of increase for young people aged 20-24 years. Spatial variability of DSS: 'Basic Education Development Index'; doctors per 10,000 inhabitants and municipal high school abandonment (MHSA) rate were associated with the risk of HIV infection among young people. The relative risk showed spatial variability. Conclusions: The SDH associated with HIV risk among young people in Pará, show social particularities of HIV in the study region and should be considered in the formulation of policies to reach the global goal of eliminating AIDS by 2030 among young people.