Spelling suggestions: "subject:"1order bealth"" "subject:"1order ashealth""
1 |
Perspectives on a US–Mexico Border Community’s Diabetes and “Health-Care” Access Mobilization Efforts and Comparative Analysis of Community Health Needs over 12 YearsRosales, Cecilia Ballesteros, de Zapien, Jill Eileen Guernsey, Chang, Jean, Ingram, Maia, Fernandez, Maria L., Carvajal, Scott C., Staten, Lisa K 10 July 2017 (has links)
This paper describes a community coalition-university partnership to address health needs in an underserved US-Mexico border, community. For approximately 15 years, this coalition engaged in community-based participatory research with community organizations, state/local health departments, and the state's only accredited college of public health. Notable efforts include the systematic collection of health-relevant data 12 years apart and data that spawned numerous health promotion activities. The latter includes specific evidence-based chronic disease-preventive interventions, including one that is now disseminated and replicated in Latino communities in the US and Mexico, and policy-level changes. Survey data to evaluate changes in a range of health problems and needs, with a specific focus on those related to diabetes and access to healthcare issues-identified early on in the coalition as critical health problems affecting the community-are presented. Next steps for this community and lessons learned that may be applicable to other communities are discussed.
|
2 |
Aspectos socioeconÃmicos e a saÃde bucal nos municÃpios da faixa de fronteiras dos arcos norte e central do brasil / Socioeconomic aspects and the oral health in the municipalities of the border strip arches North and Central BrazilMelinna dos Santos Moreno 24 June 2015 (has links)
Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / Na perspectiva de fomentar a PolÃtica Nacional de SaÃde Bucal na faixa de fronteira, foi investigada a associaÃÃo dos indicadores socioeconÃmicos/demogrÃficos e de provisÃo de saÃde com os indicadores de saÃde bucal nos municÃpios dos Arcos Central e Norte da Faixa de fronteira brasileira,em 2013. Foi conduzido um estudo baseado em dados secundÃrios oriundos dos bancos de dados eletrÃnicos oficiais do Instituto Brasileiro de Geografia e EstatÃstica, do Programa das NaÃÃes Unidas para o Desenvolvimento, do Departamento de InformÃtica do SUS e do Departamento de AtenÃÃo BÃsica. ApÃs a coleta, os dados foram processados no SPSS versÃo 17.0 e submetidos à anÃlise estatÃstica descritiva, anÃlise bivariada de associaÃÃo entre as variÃveis atravÃs do teste qui-quadrado, bem como à regressÃo linear mÃltipla e regressÃo logÃstica multinomial.O Arco Central caracterizou-se por baixa densidade demogrÃfica, enquanto, no Arco Norte, prevaleceramnÃveis satisfatÃrios de cobertura de Equipes de SaÃde da FamÃlia (ESF), na maioria dos municÃpios, bem como densidade demogrÃfica e Ãndice de Desenvolvimento Humano Municipal (IDHM) baixos. Melhores condiÃÃes socioeconÃmicas e de saÃde bucal foram verificadas no Arco Central, atestando a distribuiÃÃo desigual dos indicadores de saÃde bucal, de acordo com o arco de domicÃlio, com situaÃÃo menos favorÃvel no Arco Norte. ApÃs a anÃlise de regressÃo linear, foi constatado que, apenas no Arco Central, houve associaÃÃo positiva da cobertura de primeira consulta odontolÃgica com os indicadores de saÃde bucalmÃdia de escovaÃÃo dental supervisionada e cobertura de Equipe de SaÃde Bucal (ESB) (relaÃÃo direta), assim como com a proporÃÃo de exodontias em relaÃÃo aos procedimentos odontolÃgicos bÃsicos e com a razÃo entre procedimentos odontolÃgicos coletivos e a populaÃÃo (relaÃÃo inversa). Com a regressÃo logÃstica, foi verificada associaÃÃo da cobertura de 1 consulta odontolÃgica com a cobertura de ESF no Arco Central, assim como da proporÃÃo de exodontias com a densidade demogrÃfica e com a cobertura de ESF (Arco Central), e com o IDHM (Arco Norte). Dessa maneira, foi constatada a distribuiÃÃo desigual dos indicadores nos arcos estudados, assim como a associaÃÃo dos aspectos socioeconÃmicos/ demogrÃficos e da EstratÃgia SaÃde da FamÃlia, com indicadores de saÃde bucal nos municÃpios da Faixa de Fronteira do Brasil. / With a view to promoting the National Oral Health Policy in the border region, was investigated the association of socio-economic / demographic indicators and of health provision with oral health indicators in the municipalities of Central and North Arcos of Brazilian border in 2013. It was conducted a study based on secondary data from official electronic database of the Brazilian Institute of Geography and Statistics, the United Nations Development Programme, the Department of data processing of SUS and the Department of Primary Care. After collection, the data were processed using the SPSS version 17.0 and submitted to descriptive statistical analysis, bivariate analysis of association between variables using the chi-square test, as well as multiple linear regression and multinomial logistic regression. The Central Arco was characterized by low population density, while in North Arco, prevailed satisfactory levels of coverage of Family Health Teams (FHT), as well as low population density and Municipal Human Development Index (MHDI). Better socioeconomic and oral health conditions were observed in Central Arco, attesting to the unequal distribution of oral health indicators according to the arch of home, with less favorable situation in the Arco Norte. After linear regression analysis was found that, only in the Central Arco, there was a positive association of first dental appointment coverage with indicators of oral health average of supervised toothbrushing and oral health team (OHT) coverage (direct relation), as well as with the proportion of tooth extractions in relation to basic dental procedures and the ratio between preventive dental procedures and the population (inverse relationship). With logistic regression, was seen association of first dental visit coverage with FHT coverage in Central Arco, as well as of the proportion of tooth extractions with population density and with FHT coverage (Central Arco), and with the MHDI (North Arco). Thus, the unequal distribution of the indicators in the studied arches was found, as well as the association of socio-economic/demographic factors and of the Family Health Strategy with oral health indicators in the municipalities of the Border Range of Brazil.
|
3 |
AnÃlise de indicadores socioeconÃmicos, demogrÃficos, e de saÃde bucal do Arco Sul brasileiro / Analysis of socioeconomic, demographic and oral health indicators of Brazilian South ArcNayane Cavalcante Ferreira da Silva 25 June 2015 (has links)
CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / O Arco Sul faz parte da faixa de fronteira brasileira e abrange os estados do ParanÃ, Santa Catarina e Rio Grande do Sul. à formado por 418 municÃpios, e à a regiÃo mais afetada pela dinÃmica transfronteiriÃa. O objetivo do presente trabalho foi identificar os indicadores socioeconÃmicos, demogrÃficos e de saÃde bucal e analisar as suas associaÃÃes com os indicadores de saÃde bucal e com o nÃvel de cobertura da primeira consulta odontolÃgica dos municÃpios da faixa de fronteira do Arco Sul. Os dados foram analisados no SPSS versÃo 17.0 e intervalo de confianÃa de 95%. Nas associaÃÃes estatÃsticas foram utilizados, o teste do Qui-quadrado de Pearson, a regressÃo linear mÃltipla (p<0,05) e para a regressÃo logÃstica, o mÃtodo de Forward Stepwise (p<0,200). Os municÃpios do estado de Santa Catarina apresentaram os melhores resultados, de modo geral, em relaÃÃo aos indicadores socioeconÃmicos e demogrÃficos, quando comparados aos demais estados. Jà no aspecto dos serviÃos de saÃde, mais de 50% das cidades obteve uma excelente cobertura de Equipes de SaÃde da FamÃlia e Equipes de SaÃde Bucal e uma porcentagem acima de 80% de cobertura de Agentes ComunitÃrios de SaÃde. O Arco Sul obteve excelentes indicadores de saÃde bucal de maneira geral, porÃm apresentou uma baixa razÃo de procedimentos odontolÃgicos coletivos e uma cobertura da primeira consulta odontolÃgica de nÃveis ruim a regular. Jà nas associaÃÃes entre os indicadores de saÃde bucal com os indicadores socioeconÃmicos, demogrÃficos e de saÃde, apenas Cobertura de Equipes de SaÃde Bucal, ProporÃÃo de Exodontia e Cobertura da primeira consulta foram encontradas associaÃÃes estatisticamente significantes (p<0,05) e com a cobertura da primeira consulta odontolÃgica apenas a Cobertura de Equipes de SaÃde Bucal apresentou valores de p com significÃncia estatÃstica (p<0,05). NÃo houve relaÃÃo de multicolinearidade entre a Cobertura da primeira consulta e os demais indicadores de saÃde bucal. A partir da anÃlise desses indicadores foi possÃvel elaborar um panorama mais completo e atual acerca das condiÃÃes socioeconÃmicas e demogrÃficas e de saÃde bucal dessas localidades, com o intuito de direcionar os projetos e polÃticas existentes, nessa regiÃo, sempre em busca da melhoria da qualidade de vida da populaÃÃo da faixa de fronteira brasileira.
|
4 |
Impacting Binational Health through Leadership Development: A Program Evaluation of the Leaders across Borders Program, 2010–2014Contreras, Omar A., Rosales, Cecilia B., Gonzalez-Fagoaga, Eduardo, Valencia, Celina I., Rangel, Maria Gudelia 21 August 2017 (has links)
Background: Workforce and leadership development is imperative for the advancement of public health along the U.S./Mexico border. The Leaders across borders (LaB) program aims to train the public health and health-care workforce of the border region. The LaB is a 6-month intensive leadership development program, which offers training in various areas of public health. Program curriculum topics include: leadership, border health epidemiology, health diplomacy, border public policies, and conflict resolution. Methods: This article describes the LaB program evaluation outcomes across four LaB cohort graduates between 2010 and 2014. LaB graduates received an invitation to participate via email in an online questionnaire. Eighty-five percent (n = 34) of evaluation participants indicated an improvement in the level of binationality since participating in the LaB program. Identified themes in the evaluation results included increased binational collaborations and partnerships across multidisciplinary organizations that work towards improving the health status of border communities. Approximately 93% (n = 37) of the LaB samples were interested in participating in future binational projects while 80% (n = 32) indicated interest in the proposal of other binational initiatives. Participants expressed feelings of gratitude from employers who supported their participation and successful completion of LaB. Discussion: Programs such as LaB are important in providing professional development and education to a health-care workforce along the U.S./Mexico border that is dedicated to positively impacting the health outcomes of vulnerable populations residing in this region.
|
5 |
Project GENESIS: Community Assessment of a Rural Southeastern Arizona Border CommunityBennett, Amanda Dawn January 2009 (has links)
Purpose/Aims: The aim of this study was to understand the health issues of a rural Southeastern Arizona border community. More specifically, this study used community assessment with ethnographic principles to: 1) Conduct a community assessment centered on definitions of health, access to care, quality of care, and health needs in a rural Southeastern Arizona border community; and 2) Compared the findings of this study to previous studies, models, and theories of rural nursing and rural health.Background: It is important to understand that each community has a unique set of health priorities that are dictated by these factors; making every rural community different. Much of the work that has been done in rural America has been performed in the Midwest, Southeast, or Northern states. There is limited information regarding Arizona or even Southern US border communities and whether previous work can be generalized to areas that have not been studied.Sample and Methodology: This study utilized community assessment with ethnographic underpinnings through the use of focus groups, key informant interviews, participant observation, and secondary data analysis of existing community data. Sampling for the focus groups and key informants was purposive. Focus groups included: 1) participants who use local health services and 2) participants who do not.Analysis: Lincoln and Guba's (1985) guidelines for rigor in qualitative studies was utilized. Thematic analysis and thick description were used to analyze data. Theoretical triangulation was performed between individual, group, and community level data with theoretical linkages made to community capacity theory and rural nursing key concepts.Implications and Conclusions: The location of this project, rural Arizona community, near the US-Mexico border, posed an interesting contrast to the proposed concepts widely being used today. From this study, healthcare leaders in this community are better equipped to provide relevant, high-quality, and safe services; but an informed community emerged that has an interest in promoting the health and well-being of the community as a whole.
|
6 |
Hispanic Migrants and Cross-border Disease Control of Arizona's Vaccine Preventable DiseasesChocho, Karen 30 April 2008 (has links)
BACKGROUND: According to the Centers for Disease Control and Prevention and the National Immunization Program, there is an increase in the re-emergence of past diseases. Even with mandatory vaccination practices in the United States, there are still a number of cases of vaccine-preventable diseases (VPDs) reported yearly. It is speculated that the re-emergence of VPDs is in part due to the increase in international travel as well as the influx of immigrants. One particular group of interest includes the Hispanic migrants coming from Central and South America where some of these diseases are endemic. OBJECTIVE: The purpose of this paper is to determine the extent of VPD cases in the border state of Arizona that may be attributed to Hispanic migrant influx using data from the MMWR: Summary of Notifiable Diseases reports for the United States and the ADHS data from all Arizona counties. RESULTS: Since 1995, rates of hepatitis B and pertussis have been increasing in Arizona and have become higher for non-Hispanics than Hispanics. In 2005, hepatitis B rates were 1.53* for the United States and 7.31* for Arizona; pertussis rates were 8.72* for the United States and 21.60* for Arizona. CONCLUSION: The results of this study's analysis show the need to improve immunization efforts within the non-Hispanic populations in all Arizona counties. (*Per 100,000 population)
|
7 |
Ventanillas de Salud: A Collaborative and Binational Health Access and Preventive Care ProgramRangel Gomez, Maria Gudelia, Tonda, Josana, Zapata, G. Rogelio, Flynn, Michael, Gany, Francesca, Lara, Juanita, Shapiro, Ilan, Rosales, Cecilia Ballesteros 30 June 2017 (has links)
While individuals of Mexican origin are the largest immigrant group living in the U.S., this population is also the highest uninsured. Health disparities related to access to health care, among other social determinants, continue to be a challenge for this population. The government of Mexico, in an effort to address these disparities and improve the quality of life of citizens living abroad, has partnered with governmental and non-governmental health-care organizations in the U.S. by developing and implementing an initiative known as Ventanillas de Salud-Health Windows-(VDS). The VDS is located throughout the Mexican Consular network and aim to increase access to health care and health literacy, provide health screenings, and promote healthy lifestyle choices among low-income and immigrant Mexican populations in the U.S.
|
8 |
Produção de regiões de saúde situadas na fronteira Brasil e Uruguai / Formation of the health regions along the border between Brazil and UruguayLemões , Marcos Aurélio Matos 16 December 2016 (has links)
Submitted by Aline Batista (alinehb.ufpel@gmail.com) on 2018-04-12T13:54:47Z
No. of bitstreams: 2
license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)
Tese_Marcos_Aurelio_Matos_Lemoes.pdf: 1674974 bytes, checksum: 4f393b06817a591cbb3e8641e9a32578 (MD5) / Made available in DSpace on 2018-04-12T14:56:14Z (GMT). No. of bitstreams: 2
license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)
Tese_Marcos_Aurelio_Matos_Lemoes.pdf: 1674974 bytes, checksum: 4f393b06817a591cbb3e8641e9a32578 (MD5)
Previous issue date: 2016-12-16 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / A presente tese foi construída a partir de um recorte da pesquisa realizada na fronteira entre o Brasil e o Uruguai intitulada “Identificação de Indicadores para o monitoramento e avaliação dos impactos da nova política uruguaia de regulação do mercado de Cannabis sobre a saúde pública e o consumo de drogas na zona de fronteira entre Brasil e Uruguai” financiada pela Secretaria Nacional de Drogas do Ministério da Justiça SENAD/MJ. Utilizou-se o banco de dados qualitativo de municípios pesquisados sobre o eixo saúde pública. O estudo buscou reconhecer como se produz no cotidiano da gestão, regiões de saúde em municípios considerados cidades gêmeas entre o Brasil e o Uruguai. Na pesquisa foram entrevistados gestores municipais e gestores de saúde do Brasil e do Uruguai totalizando 14 municípios. A coleta de dados deu-se por entrevista semiestruturada com perguntas abertas sobre gestão em saúde e questões fechadas para realizar a caracterização do município e perfil dos participantes. Para este estudo optou-se por realizar a análise de conteúdo proposta por Bardin, (2011). Neste método foram designados três polos cronológicos a pré analise, a exploração do material e o tratamento dos resultados a inferência e a interpretação. No estudo optou-se como referencial teórico o Postulado de coerência de Carlos Matus e Mário Testa e a proposta teórica de Rogério
Haesbaert para a multiterritorialidade. A coleta de dados deu-se após aprovação do Comitê de ética e Pesquisa parecer número1.757.934 no mês de outubro de 2016. Verificou-se que os gestores destes municípios enfrentam diariamente a fluidez do espaço utilizado por usuários nacionais e estrangeiros que utilizam os serviços de saúde para sanar os problemas de saúde. Por ser considerada uma
fronteira aberta, é difícil ordenar e quantificar os atendimentos a estrangeiros, fato este que incide nos registros e sistemas de informações do Ministério da Saúde por indisponibilidade de alimentação de dados sobre estrangeiros. Os atendimentos na maioria nos municípios ainda ocorrem em situações de
urgência e emergência, com vínculos precários e baixa cooperação entre os países. Os gestores anunciam que se utilizam do poder político para definir a contratação de médicos uruguaios e aderir ao Programa Mais Médicos, acarretando disputas judiciais com o Sindicato Medico do Rio Grande do Sul. A definição estratégica e forma de implementação de políticas, são definidas por uma visão intrínseca e fortemente vinculada ao sub financiamento da saúde. / This thesis was built from part of a research carried out along the border between Brazil and Uruguay titled “identifying indicators for monitoring and evaluating the new Uruguayan political impacts on public health and drug consumption caused by the cannabis market regulation along the border area between Brazil and Uruguay" funded by the National Secretariat of Drugs of the Ministry of Justice SENAD / MJ. The aim of the study was to understand the formation of health regions from the Situational strategic planning in twin cities between Brazil and Uruguay. It was used a qualitative database of the cities
searched on the axis public health. In the survey, the respondents were municipal managers and health managers in Brazil and Uruguay totaling 14 municipalities. Data collection occurred by semistructured interview with open questions on health management and closed questions designed to perform the
characterization of the city and profile of participants. For this study it was decided to carry out the content analysis proposed by Bardin (2011). It was chosen also as a theoretical basis, the Postulate of Coherence of Carlos Matus and Mario Testa, and, the theoretical proposal of Rogério Haesbaert for multiterritoriality. Data collection occurred after approval by the Ethics and Research Committee Opinion number 1,757,934 in October 2016. It was found that the managers of those cities daily face the fluidity of space used by domestic and foreign users who use health services to address the health problems. Because it is considered an open border, it is difficult to sort and quantify the calls to foreigners, a fact that focuses on the records and information systems of the Ministry of Health, due to the unavailability of data on foreign supply. The health calls in most cities still occur in urgent and emergency situations, with poor bonds and low cooperation between the countries. Managers claim about the use of political power to set the hiring of Uruguayan doctors and to join the More Doctors – a Brazilian Program - causing disputes with the Medical Union of Rio Grande do Sul state. The strategic definition and form of policy implementation are defined by an intrinsic vision and are strongly linked to the health underfunding.
|
9 |
Trajectoires d'européanisation : une comparaison des usages de l'Europe dans le secteur de la santé en Suède et en France (1945-2015) / Trajectories of Europeanisation : a comparison of usages of Europe in the health sector in France and Sweden (1945-2015)Davesne, Alban 11 October 2017 (has links)
Cette thèse de science politique propose de comparer l’européanisation des politiques de santé en Suède et en France dans une perspective historique et interactionniste. Depuis les années 1990, de nombreuses études ont démontré l’importance croissante des interventions de l’Union européenne dans le domaine de la santé. Mais peu de travaux se sont interrogés sur la manière dont l’institutionnalisation de l’action publique européenne s’articule avec les changements des politiques de santé nationales sur la longue durée. Partant du postulat selon lequel les systèmes de santé font partie des secteurs les plus solidement ancrés dans les espaces nationaux et sont organisés selon des modèles institutionnels très divers, il s’agit de comprendre comment les dimensions européennes des politiques de santé ont été construites et incorporées dans les systèmes nationaux. La comparaison entre les politiques de santé en Suède et en France se justifie d’une part par le fait que ces pays correspondent à deux grands types d’organisation des systèmes de santé existant au sein de l’Union européenne, respectivement les systèmes nationaux de santé et les systèmes d’assurance maladie, et d’autre part en raison de l’histoire européenne contrastée de ces deux pays, la France étant un État-membre fondateur et la Suède n’ayant rejoint l’UE que tardivement et sans enthousiasme. Nous pouvons ainsi démontrer sur une période longue et pour deux cas contrastés que les effets de l’intégration européenne ne se réduisent pas aux pressions européennes sur des systèmes de santé plus ou moins fit. En retraçant les trajectoires d’européanisation des politiques de santé suédoises et françaises sur une longue période et pour plusieurs enjeux clefs des modèles nationaux en termes d’organisation des soins (démographie médicale et choix des patients) et de santé publique (lutte contre le cancer, le tabagisme et l’alcoolisme), cette thèse montre que l’européanisation des politiques de santé est le fruit d’un travail politique ancien de construction d’acteurs domestiques en interactions. / This PhD thesis, in the field of political science, offers to compare the Europeanisation of health policies in France and Sweden, in a historic and interactionist perspective. Since the 1990s, numerous studies have shown the growing significance of the European Union’s intervention in the health sector. However, few of them have looked at how the institutionalisation of European public action interplays with national health policy changes in a long-term approach. Based on the premise that health systems are strongly embedded in national settings and are organised along very different institutional models, the aim is to understand how the European dimension of health policies have been built and incorporated into national systems. The comparison between health policies in Sweden and France is justified on the one hand by the fact that each country represents one of the two main type of health systems existing in the European Union, the national health and national insurance system respectively; and on the other hand by the contrasting European histories of these two states, France being one of the founding members and Sweden having joined the EU at a later stage and with little enthusiasm. We can thus show on a long period of time, and for two different cases, that the effects of European integration cannot be reduced to European pressures on health systems that are more or less fit. By tracing the trajectories of Europeanisation of Swedish and French health policies on a long period, and for key issues for the national models regarding healthcare services (demography of health care professionals and patient’s choice) and public health (fight against cancer, tobacco and alcohol addictions), this dissertation shows that the Europeanisation of health policies results from the long-term political work of construction of domestic actors in interaction.
|
10 |
Mortalidade por tuberculose e tuberculose-HIV, sua relação espacial com os determinantes sociais e tendência temporal: uma abordagem multimétodo em Foz do Iguaçu, PR / Mortality due to tuberculosis and HIV-tuberculosis, its spatial relationship with social determinants and temporal trend: a multi-method approach in Foz do Iguaçu, PRArcoverde, Marcos Augusto Moraes 26 November 2018 (has links)
A tuberculose (TB) é um grave problema de saúde pública, acometendo milhares de pessoas, principalmente em populações ou grupos menos favorecidos. A região de fronteira, devido ao aumento do fluxo de pessoas, constitui um desafio para o controle da TB. Nesse contexto, o objetivo geral do trabalho foi \"Analisar a relação espacial de determinantes sociais da saúde com a mortalidade por TB e por TB-HIV e tendência temporal desses eventos em Foz do Iguaçu, PR\". Como abordagem teórica, foi utilizado o marco conceitual dos Determinantes Sociais da Saúde. Trata-se de um estudo ecológico com aplicação de múltiplos métodos de análise. A população consistiu de casos de óbitos por TB como causa básica e TB associado com HIV (coinfecção TB-HIV) residentes em Foz do Iguaçu, no período de 2004 a 2015 e as unidades de análise foram os setores censitários urbanos. Os dados referentes aos óbitos foram coletados no Sistema de Informação de Mortalidade (SIM). As variáveis originais que representaram os determinantes sociais foram coletadas do Censo Demográfico 2010 do Instituto Brasileiro de Geografia e Estatística (IBGE). Quanto aos métodos de análises, foram realizadas análise descritiva dos óbitos, Estimador de densidade Kernel, estatística de varredura, distribuição e análise estatística das taxas de mortalidade, análise de dependência espacial (I Moran), Associação espacial (Índice Local de Associação Espacial - LISA e Gi*), Regressão Geograficamente Ponderada [RGP, em inglês - Geographically Weighted Regression (GWR)] e análise de tendência temporal (regressão temporal Prais-Wistein). Os resultados da análise descritiva demonstraram que dos 130 casos de óbitos no período, 74 ocorreram por TB como causa básica e 56 pela coinfecção TB-HIV. Para os dois grupos estudados a maioria era homens [TB = 53 (71,6%); TB-HIV = 43 (76,8%)], de raça/cor de pele branca [TB = 51 (68,9%); TB-HIV = 43 (76,8)], solteiros [TB = 36 (48,6%); TB-HIV = 35 (62,5%)], com ensino fundamental [TB = 34 (45,9%); TB-HIV = 25 (44,6%)] e com TB pulmonar [TB = 67 (90,5%); TB-HIV = 48 (85,7%)]. Os óbitos pela coinfecção TBHIV foram mais jovem em relação aos óbitos por TB. A técnica de estimador de densidade Kernel demonstrou pontos quentes para os óbitos por TB nas regiões Leste e Sul, enquanto que para os óbitos de TB-HIV foram as regiões Norte, Nordeste, Leste e Sul. A estatística de varredura apontou um cluster de risco relativo espacial aumentado 5,07 (IC95% 1,79 - 14,30) na região leste. As taxas de mortalidade foram 2,2/100mil hab. para TB e 1,8/100mil hab. para TB-HIV. A partir da técnica Gi*, observou-se que a taxa de mortalidade por TB apresentou áreas quentes na região Sul, Leste e Central, enquanto que a taxa de mortalidade por TB-HIV apresentou nas regiões Norte, Nordeste e Leste. A associação bivariada (LISA) demonstrou que o padrão predominante foi a associação das altas taxas de uma mortalidade com a baixa taxa da outra, ou seja, alto-baixo (High-Low) e baixo-alto (Low-High). Ocorreu ainda associação do padrão alto-alto (High-High), não sendo observado a associação baixobaixo. A associação local (LISA) entre os determinantes sociais e a mortalidade por TB apontou a renda, cor de pele e densidade de moradores por domicílio como fatores associados. Já em relação a taxa de mortalidade por TB-HIV, a técnica GWR, os determinantes indicados foram renda, raça/cor de pele parda e esgoto a céu aberto. Em relação à tendência temporal, observou-se um crescimento da mortalidade de TB em pessoas de raça/cor de pele parda. Os resultados contribuem para reflexão sobre a relevância da adoção de estratégias intersetoriais para a redução das desigualdades sociais afim de evitar as mortes por TB e TB-HIV em territórcios com grande vulnerabilidade / Tuberculosis (TB) is a serious public health problem, affecting thousands of people, especially in disadvantaged populations or groups. Border regions constitute a challenge for the control of TB, due to the constant increase in the flow of people. In this context, the general objective of this study was to \"Analyze the spatial relationship of social determinants of health with mortality from TB and HIV-TB and its temporal tendency in Foz do Iguassu, PR\". As a theoretical approach, the study opted for the conceptual framework of the Social Determinants of Health. It is an ecological study with application of multiple methods of analysis. The population of this study consisted of cases of deaths due to TB as a basic cause and TB associated with HIV (TB-HIV co-infection) residing in Foz do Iguassu, from 2004 to 2015, and the analysis units were the urban census tracts. Data on deaths were collected in the Mortality Information System (SIM). The original variables that represented the social determinants were collected from the 2010 Demographic Census of the Brazilian Institute of Geography and Statistics (IBGE). As for the methods of analysis, this study focused on descriptive analysis of deaths, Kernel Density Estimator, Scan Statistics, Distribution and statistical analysis of mortality rates, spatial dependence (I Moran), Spatial Association (Local Spatial Association Index - LISA and Gi *), Geographically Weighted Regression (GWR) and temporal trend analysis (Prais-Wistein temporal regression). The results of the descriptive analysis showed that of the 130 cases of death in the period, 74 occurred because of TB as the basic cause and 56 because of TB-HIV co-infection. For the two groups studied the majority were men [TB = 53 (71,6%); TB-HIV = 43 (76,8%)], of race/color of white skin [TB = 51 (68,9%); TB-HIV = 43 (76,8)], single [TB = 36 (48,6%); TB-HIV = 35 (62,5%)], with elementary education (TB = 34 (45,9%); TB-HIV = 25 (44,6%)) and with pulmonary TB [TB = 67 (90,5%); TBHIV = 48 (85,7%)]. Deaths from TB-HIV coinfection were younger in relation to TB deaths. The Kernel intensity estimator technique demonstrated hot spots for TB deaths in the eastern and southern regions, while for the deaths of HIV-TB were the north, northeast, east and south. The scan statistic pointed to a cluster of spatial relative risk increased by 5.07 (95% CI 1.79 - 14.30) in the eastern region. Mortality rates were 2.2/100mil for TB and 1.8 / 100 thousand inhabitants for HIV-TB. From the Gi * technique, it was observed that the TB mortality rate presented hot areas in the south, east and central regions, while the mortality rate due to TB-HIV presented in the north, northeast and east regions. The bivariate association (LISA) showed that the predominant pattern was the association of the high rates of one mortality with the low rate of the other, that is, high-low and low-high. There was also association of the highhigh pattern, and the low-low association was not observed. The local association (LISA) between the social determinants and the mortality by TB indicated the income, skin color and density of residents per household as associated factors. Regarding the mortality rate due to HIV-TB, the GWR technique, the determinants indicated were income, race / color of brown skin and open sewage. Regarding the temporal trend, there was an increase in the mortality of TB in people of race / color of brown skin. The bivariate association (LISA) showed that the predominant pattern was the association of the high rates of one mortality with the low rate of the other, that is, high-low and low-high. There was also association of the high-high pattern, and the low-low association was not observed. The local association (LISA) between the social determinants and the mortality by TB indicated the income, skin color and density of residents per household as associated factors. Regarding the mortality rate due to HIVTB, the GWR technique, the determinants indicated were income, race / color of brown skin and open sewage. Regarding the temporal trend, there was an increase in the mortality of TB in people of race / color of brown skin. Regarding the temporal trend, there was an increase in the mortality of TB in people of race / color of brown skin. The results contribute to a reflection on the relevance of adopting intersectoral strategies to reduce social inequalities in order to avoid deaths due to TB and HIV-TB in highly vulnerable territories
|
Page generated in 0.0809 seconds