Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-01-16T18:04:01Z No. of bitstreams: 1 LillianKariellyDeAraujoGomes_DISSERT.pdf: 644818 bytes, checksum: 198f9eb2d8a797afd8581fc929b326f5 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-01-22T11:44:35Z (GMT) No. of bitstreams: 1 LillianKariellyDeAraujoGomes_DISSERT.pdf: 644818 bytes, checksum: 198f9eb2d8a797afd8581fc929b326f5 (MD5) / Made available in DSpace on 2018-01-22T11:44:35Z (GMT). No. of bitstreams: 1 LillianKariellyDeAraujoGomes_DISSERT.pdf: 644818 bytes, checksum: 198f9eb2d8a797afd8581fc929b326f5 (MD5) Previous issue date: 2017-08-31 / O Brasil tem enfrentado, nas ?ltimas d?cadas, mudan?as no seu perfil sociodemogr?fico, epidemiol?gico e nutricional. Altera??es do perfil epidemiol?gico e demogr?fico foram concomitantes. A Diabetes Mellitus (DM) tipo 2 n?o insulinodependente, se destaca como doen?a que tem avan?ado significativamente como causa de mortalidade. Ressalta-se que vari?veis como idade, sexo, escolaridade e renda, podem ter um relevante poder explicativo para a mortalidade por essa doen?a. Assim, o objetivo geral deste trabalho ? analisar e descrever o comportamento das taxas de mortalidade por DM tipo 2 (TMDM), na popula??o brasileira, em termos de grandes regi?es e UF, investigando sua associa??o com fatores sociodemogr?ficos selecionados, tomando por refer?ncia o per?odo de 2000-2015. Foram utilizadas, como fontes de dados, o Sistema de Informa??es sobre Mortalidade (SIM) e o Atlas do Desenvolvimento Humano do Brasil (Atlas BR-2013), do PNUD. Trata-se de um estudo descritivo e multivariado, com foco nas TMDM n?o insulinodependente, as quais foram padronizadas pela popula??o do Brasil, onde as UF brasileiras foram tomadas como unidades b?sicas de an?lise, o que, tamb?m o caracteriza como estudo ecol?gico. Foram realizadas an?lises descritivas, observando-se o comportamento trienal das taxas. Foi empregado ajuste do Modelo de Regress?o Linear M?ltipla (MRLM), ponderado pelo tamanho da popula??o, tomando-se a TMDM (logito da taxa m?dia dos ?ltimos quatro anos, 2012-15), como vari?vel resposta e indicadores de educa??o, renda e pobreza, como vari?veis explicativas. Tamb?m foi realizada an?lise estat?stica n?o param?trica, com emprego do Teste de Mann-Whitney, para medir as signific?ncias das diferen?as das TMDM e indicadores sociodemogr?ficos entre dois grupos de UF, sendo um representado pelas regi?es Norte e Nordeste e outro por UF das regi?es Sul, Sudeste e Centro-Oeste. Em todas as an?lises, o n?vel de signific?ncia foi de 5%. Os resultados apontaram associa??es estatisticamente significantes entre as TMDM e os indicadores sociodemogr?ficos analisados (indicadores de pobreza, educa??o e desigualdade de renda). No ajuste do MRLM, a ?nica vari?vel estatisticamente significante, para explicar a varia??o das TMDM, foi o indicador de pobreza (propor??o de pessoas vivendo com menos de 1/2 sm), (p-valor=0,027), apontando que, quanto mais pobre e menos desenvolvida a UF, maiores s?o seus n?veis de mortalidade por DM (r=0,43). O Teste de Mann-Whitney mostrou diferen?as estatisticamente significantes para todas as vari?veis sociodemogr?ficas e as TMDM entre os dois grupos considerados. Por fim, ? poss?vel destacar que, apesar dos avan?os socioecon?micos, todas as regi?es do pa?s apresentaram crescimento em suas TMDM, notadamente naquelas com condi??es sociais e educacionais menos favorecidas. A necessidade de pol?ticas p?blicas mais eficientes e de maior alcance social se constitui como premissa urgente no tocante a uma melhoria nessa rela??o sa?de-espa?o no Brasil. / In recent decades, Brazil has faced changes in its sociodemographic, epidemiological and nutritional profile. Changes in the epidemiological and demographic profile were concomitant. Type 2 non-insulin dependent diabetes mellitus (DM) stands out as a disease that has progressed significantly as a cause of mortality. It should be pointed out that variables such as age, sex, schooling and income may have a relevant explanatory power for mortality from this disease. Thus, the general objective of this work is to analyze and describe the behavior of mortality rates due to Type 2 DM (TMDM) in the Brazilian population, in terms of large regions and UF, investigating its association with selected sociodemographic factors, taking as a reference the period 2000-2015. The Mortality Information System (SIM) and the Human Development Atlas of Brazil (Atlas BR-2013) of the UNDP were used as data sources. It is a descriptive and multivariate study, focusing on non-insulin dependent TMDM, which were standardized by the population of Brazil, where Brazilian UF were taken as basic units of analysis, which also characterizes it as an ecological study. Descriptive analyzes were performed, observing the three-year behavior of the rates. A multi-regression model (MRLM) was used, weighted by population size, using TMDM (average rate logito of the last four years, 2012-15) as a response variable and indicators of education, income and poverty, as explanatory variables. A non-parametric statistical analysis, using the Mann-Whitney Test was used to measure the significance of TMDM differences and sociodemographic indicators between two groups of UF, one represented by the North and Northeast regions and another by UF of the South, Southeast and Central West. In all analyzes the level of significance was taken as 5%. The results pointed to statistically significant associations between TMDM and the sociodemographic indicators analyzed (indicators of poverty, education and income inequality). In the adjustment of MRLM, the only statistically significant variable, to explain the variation of TMDM, was the poverty indicator (proportion of people living with less than 1/2 sm), (p-value = 0.027), indicating that the poorer and less developed the UF, the higher are their DM mortality rates (r = 0.43). The Mann-Whitney Test showed statistically significant differences for all sociodemographic variables and TMDM, between the two groups considered. Finally, it is possible to emphasize that, despite the socioeconomic advances, all the regions of the country presented growth in their TMDM, especially in those with less favored social and educational conditions. The need for more efficient and more effective public policies is an urgent premise, regarding an improvement in this health-space relationship in Brazil.