Artículos y presentaciones en Congresos
URI permanente para esta colección
Examinar
Envíos recientes
- Artículo
Acceso Abierto Socioeconomic Gradients in Chronic Disease Risk Factors in Middle-Income Countries: Evidence of Effect Modification by Urbanicity in Argentina(American Public Health Association, 2011) Fleischer, Nancy; Diez Roux, Ana V.; Alazraqui, Marcio; Spinelli, Hugo; De Maio, FernandoObjectives. We investigated associations of socioeconomic position (SEP) with chronic disease risk factors, and heterogeneity in this patterning by provincial-level urbanicity in Argentina. Methods. We used generalized estimating equations to determine the relationship between SEP and body mass index, high blood pressure, diabetes, low physical activity, and eating fruit and vegetables, and examined heterogeneity by urbanicity with nationally representative, cross-sectional survey data from 2005. All estimates were age adjusted and gender stratified. Results. Among men living in less urban areas, higher education was either not associated with the risk factors or associated adversely. In more urban areas, higher education was associated with better risk factor profiles (P<.05 for 4 of 5 risk factors). Among women, higher education was associated with better risk factor profiles in all areas and more strongly in more urban than in less urban areas (P<0.05 for 3 risk factors). Diet (in men) and physical activity (in men and women) were exceptions to this trend. Conclusions. These results provide evidence for the increased burden of chronic disease risk among those of lower SEP, especially in urban areas. - Artículo
Acceso Abierto Desigualdades en salud y desigualdades sociales: un abordaje epidemiológico en un municipio urbano de Argentina(Pan American Health Organization (PAHO), 2007) Alazraqui, Marcio; Mota, Eduardo; Spinelli, Hugo; Guevel, CarlosObjetivos. Establecer la relación entre algunos indicadores sociales y de salud en el nivel local mediante una combinación de métodos epidemiológicos y de referencias geográficas. Métodos. El trabajo se realizó en los 431 radios censales del municipio de Lanús, provincia de Buenos Aires, Argentina, en el período comprendido entre enero de 1995 y diciembre de 2002. Se estratificaron los radios censales mediante un estudio por conglomerados o clústeres según sus características demográficas y socioeconómicas, se analizó la distribución de los eventos del proceso de salud-enfermedad-atención mediante su localización geográfica (georreferencias) y se comparó la distribución de esos eventos a través de diagramas de caja (box-plot) por grupos. La información demográfica y socioeconómica se obtuvo del Censo Nacional de Población y Vivienda de 1991 para cuatro aspectos de la población: características de la vivienda, nivel educacional, nivel de hacinamiento y personas mayores de 65 años que vivían en la vivienda. Los indicadores de salud fueron: la cobertura de vacunación de niños al momento del ingreso escolar, las tasas de embarazo en adolescentes y las tasas de mortalidad por tumores de mama en mujeres mayores de 40 años. Resultados. La mediana del número de adolescentes embarazadas disminuyó a medida que mejoraban las condiciones socioeconómicas (χ2 = 60,7452; P = 4,074 × 10– 13), mientras que la de la mortalidad por tumores de mama en mujeres mayores de 40 años fue mayor en el estrato con mejores condiciones de vida (χ2 = 12,9766; P = 0,0047). La mediana del número de niños con el esquema de vacunación incompleto al ingreso escolar disminuyó a medida que mejoraban las condiciones socioeconómicas, aunque de manera no significativa (χ2 = 6,3993; P = 0,0937). Conclusiones. La combinación de métodos empleados permitió comprobar la relación existente entre los indicadores sociales y los indicadores del proceso salud-enfermedadatención, en particular, la tasa de embarazos en adolescentes y la mortalidad por tumores de mama en mujeres mayores de 40 años. Estos resultados son de gran utilidad para diseñar intervenciones específicas dirigidas a reducir desigualdades en el nivel local. - Artículo
Acceso Abierto Estudo multicêntrico da mortalidade por homicídios em países da América Latina(ABRASCO - Associação Brasileira de Saúde Coletiva, 2012) Ramos de Souza, Edinilsa; Nascimento de Melo, André; Guimarães e Silva, Juliana; Franco, Saúl Alonso; Alazraqui, Marcio; González-Pérez, Guillermo JuliánThis article is a descriptive epidemiological study of deaths by homicide in Latin American countries (Argentina, Brazil, Colombia and Mexico) from 1990 to 2007. Deaths due to external causes and homicides, as codified in the 9th and 10th revisions of the International Classification of Diseases/ICD, were analyzed considering sex, age and manner of assault. The numbers, ratios and adjusted rates for deaths by homicide are presented. A linear regression model was used to ascertain the trend of homicide rates by age group. During the period, 4,086,216 deaths from external causes and 1,432,971 homicides were registered in these countries. Deaths from external causes rose 54.5% in Argentina but fell in the other countries (37% in Mexico, 31.8% in Colombia, and 8.1% in Brazil). The ratio for deaths by homicide for both sexes was 9.1 in Colombia, 4.4 in Brazil and 1.6 in Mexico, using the Argentinian rates as a benchmark. There were differences in the evolution of homicide rates by age and sex in the countries: the rate rose in Brazil and fell in Colombia for all age groups. The need to prioritize young males in public policies related to health care and prevention is stressed, as well as the need for the region to adopt inclusive policies and broaden and consolidate democracy and the rights of inhabitants. - Artículo
Acceso Abierto Firearm-related deaths and crime in the autonomous city of Buenos Aires, 2002(ABRASCO - Associação Brasileira de Saúde Coletiva, 2006) Spinelli, Hugo; Alazraqui, Marcio; Zunino, Gabriela; Olaeta, Hernán; Poggese, Héctor; Concaro, Carola; Porterie, SidonieViolence is one of the most serious challenges in Latin American societies. Possession and use of small arms and light weapons are considered to be among the main factors behind it. The aim of this paper is to describe deaths and crimes involving the use of a firearm in the City of Buenos Aires in 2002, focusing the health, justice and police sectors. Data on mortality and crimes were obtained from the National Systems for vital statistics and criminal information; data on firearm seizures were supplied by the Argentine Federal Police. Household interviews conducted for a previous research on firearm-related victimization were also used. An index of violent incidents was developed by police station. There were 1,304 deaths from violence, of which 23.7% were caused by a firearm. The police filed 171 proceedings on the charge of homicides with criminal intent, of which 60% had been committed with a firearm. Of the 2,108 interviewed individuals, 6.7% were victims of a crime committed with a firearm. In 9.6% of surveyed households there was a firearm. Seized firearms added up to 1,887. The index of violent incidents was higher in police stations in the southwestern area of the city that has worse living conditions. The impact of violence and its relation to firearms features as a major issue in the public agenda. - Artículo
Acceso Abierto Validade de constructo da escala Experiences of Discrimination em uma população brasileira(Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation (ENSP-FIOCRUZ), 2016) Fattore, Gisel Lorena; Teles, Carlos Antonio; Santos, Darci N. dos; Santos, Leticia M.; Reichenheim, Michael Eduardo; Barreto, Mauricio L.Um dos instrumentos mais utilizados na pesquisa epidemiológica sobre discriminação é o Experiences of Discrimination (EOD), utilizada no Brasil, porém não validado. O objetivo foi avaliar a confiabilidade e estrutura dimensional da escala EOD em uma população brasileira. Foi conduzido um estudo transversal com 1.380 adultos da cidade de Salvador, Bahia, Brasil. Realizou-se análise fatorial confirmatória (AFC) testando um modelo de dois fatores: experiência de discriminação e preocupação por discriminação. Os resultados da AFC mostraram parâmetros satisfatórios de ajuste, elevadas cargas fatoriais e valores adequados de confiabilidade, confirmando a consistência interna da escala. Identificaram-se correlações residuais envolvendo itens de ambos os fatores. A estrutura dimensional apresentada neste estudo destaca a importância de utilizar diferentes medidas de discriminação – interpessoais e grupais – que permitam em estudos futuros aprofundar nos efeitos do racismo sobre a saúde. - Artículo
Acceso Abierto Socioeconomic and environmental determinants of adolescent asthma in urban Latin America: an ecological analysis(Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation (ENSP-FIOCRUZ), 2015) Fattore, Gisel Lorena; Santos, Carlos Antonio de S. T.; Barreto, Mauricio L.The prevalence of asthma is high in urban areas of many Latin-American countries where societies show high levels of inequality and different levels of development. This study aimed to examine the relationship between asthma symptoms prevalence in adolescents living in Latin American urban centers and socioeconomic and environmental determinants measured at the ecological level. Asthma prevalence symptoms were obtained from the International Study of Asthma and Allergies in Childhood (ISAAC) phase III. A hierarchical conceptual framework was defined and the explanatory variables were organized in three levels: distal, intermediate, proximal. Linear regression models weighed by sample size were undertaken between asthma prevalence and the selected variables. Asthma prevalence was positively associated with Gini index, water supply and homicide rate, and inversely associated with the Human Development Index, crowding and adequate sanitation. This study provides evidence of the potential influence of poverty and social inequalities on current wheezing in adolescents in a complex social context like Latin America.