Obesity prevalences are increasing in Sweden and the US. Obesity has many health consequences and health risks are associated with small increases in weight and marked obesity. Cross-sectional and panel surveys from northern Sweden and upstate NY provide the basis for furthering understanding of body mass index (BMI) development. BMI and weight change (+/-3%) were used to evaluate obesity and weight loss, maintenance, or gain. The 1989 prevalences of obesity were 9.6% and 21.3% in Sweden and the US; 1999 prevalences were 18.4% and 32.3%. Ten-year incidences (1989-1999) of overweight and obesity were 337/1000 and 120/1000 for Sweden and 336/1000 and 173/1000 for the US. Cross-sectional data suggest obesity is a problem of older age while panel data show that the young are gaining weight most rapidly. Individual changes in BMI have similar trends for Sweden and the US; the majority of adults are gaining weight. Older age, being a woman, higher BMI, and type 2 diabetes were associated with higher odds of weight non-gain. Younger age, being a man, being married and using snuff (snus) increased the odds of weight gain. The obese were 2-7 times more likely to report self-rated poor health. Healthy behaviours explain more of the person-to-person variability in BMI than do unhealthy behaviours or chronic diseases. Encouraging trends were found among Västerbotten Intervention Programme participants: a higher proportion of adults maintained weight in more recent survey years. The proportion of weight-gaining adults with identified health risk factors is smaller than those without risk factors. Frequently weight maintenance is felt to be important only for those identified as having a problem with weight or an obesity-related health condition. The largest proportion of those gaining weight are those with a normal BMI. Obesity prevention should target those usually considered low-risk (young, without cardiovascular risk factors, normal BMI).

Work is an essential part of most people’s lives. With increasing flexibility in work life, many employees experience job insecurity – they perceive that the future of their jobs is uncertain. However, job insecurity is not just an individual experience; employees can perceive that there is a climate of job insecurity at their workplace as well, as people collectively worry about their jobs. The overall aim of this thesis was to investigate the job insecurity climate construct and how it relates to work- and health-related outcomes and to individual job insecurity. Three empirical studies were conducted to investigate this aim. Study I investigated the dimensionality of the job insecurity construct by developing and testing a measure of job insecurity climate − conceptualized as the individual’s perception of the job insecurity climate at work − in a sample of employees working in Sweden. The results indicated that individual job insecurity and job insecurity climate are separate but related constructs and that job insecurity climate was related to work- and health-related outcomes. Study II examined the effects of individual job insecurity and job insecurity climate on work- and health-related outcomes in a sample of employees working in a private sector company in Sweden. The results showed that perceiving higher levels of job insecurity climate than others in the workgroup was associated with poorer self-rated health and higher levels of burnout. Study III tested the relationship between individual job insecurity and job insecurity climate in a sample of Flemish employees. The results indicated that individual job insecurity is contagious, as individual job insecurity predicted perceptions of job insecurity climate six months later. In conclusion, by focusing on perceptions of the job insecurity climate, the present thesis introduces a new approach to job insecurity climate research, showing that employees can perceive a climate of job insecurity in addition to their own individual job insecurity and, also, that this perception of the job insecurity climate at work has negative consequences for individuals and organizations. / <p>At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 2: Manuscript. Paper 3: Manuscript.</p>

INTRODUCTION. Quality of life (QOL) – and individual’s perception of his or her own health – has become the subject of great interest in Lithuania. THE AIM OF THE STUDY. The aim of the study was to assess the determinants of the quality of life and self-rated health and to clarify the importance of perceived health in determining the risk of death among middle-aged Kaunas population. MAIN RESULTS. Quality of life in middle-aged Kaunas women was found to be lower than in men, except for the spirituality domain. Older age showed worse quality of life. Low income and lower educational level, manual work, living alone, unemployment, disability and retirement were associated with worse QOL in middle-aged Kaunas population. Overweight and obese men had lower probability of rating their overall QOL worse as compared to men with normal body mass. Diabetes, coronary heart disease and smoking were associated with worse QOL in men. Moderate-to-heavy alcohol consumption was associated with lower risk of having worse QOL as compared to light alcohol consumption group among men. Obesity for women increased the odds of having worse QOL as compared to women with normal body mass. Moderate-to-heavy alcohol consumption was associated with better QOL in the physical and independence domains and with worse QOL in the social relationships domain among women. Smoking and inadequate physical activity were associated with worse QOL among women. CHD increased women’s probability of scoring lower in... [to full text]

Material and methods Characteristics of study population The entire adult population (patients 16 years or older) of two PHC doctors practices in Kaunas were invited to participate in study. Approval from the Kaunas University of Medicine Ethics Committee was obtained and participants signed a written informed consent prior to examination. Patients from one practice were intervention community, patients from another practice - control community. In intervention community 1219 patients 16 years or older participated in first survey (506 men and 713 women, response rate 87.1%), in control community – 1068 patients (439 men and 629 women, response rate 87.1%). Intervention, oriented to improve control of risk factors of NCD, was integrated into the PHC team daily practice during one year in intervention community. Control community was receiving usual PHC. After one year (in 2000) all participants of first survey were invited to participate in second survey. Each survey followed the same methods. In intervention community 1069 patients (506 men and 713 women, response rate 87.7%) participated in second survey, in control community - 940 patients (439 men and 629 women, response rate 88.0%). There was no difference between communities concerning age and sex distribution of participants (table 2.1.1). Table 2.1.1 Distribution of respondents by age and sex in intervention and control communities Age,years Intervention community Control community Men women total men women... [to full text]

Introduction : Une majorité de Canadiens adopte un mode de vie sédentaire qui est un facteur de risque important pour différents problèmes de santé. Dernièrement, des interventions en santé publique ciblent le transport actif pour augmenter la pratique d’activité physique. Objectif : L’objectif de cette étude est de quantifier la direction et la taille de l’association entre l’état de santé rapporté par des adultes montréalais et leur utilisation de la marche et du vélo utilitaires. Méthode : L’échantillon comprend 4503 résidents de l’Île de Montréal, âgés de 18 ans et plus, ayant répondu à un sondage téléphonique sur la pratique de l’activité physique et du transport actif. Des analyses de régression logistique multiples ont été appliquées pour examiner l’association entre l’état de santé auto-rapporté et la pratique du vélo (N=4386) et entre l’état de santé auto-rapporté et la pratique de la marche utilitaire (N=4350). Résultats : Les gens ayant une santé perçue comme bonne et moyenne/mauvaise ont une probabilité plus faible de pratiquer la marche utilitaire (OR = 0,740; p < 0,05 et OR = 0,552; p < 0,01) que ceux rapportant une excellente santé, alors que cette association n’est pas significative pour la pratique du vélo utilitaire dans notre étude. Conclusion : Bien que les résultats obtenus ne soient pas tous statistiquement significatifs, la probabilité d’utiliser le transport actif semble plus faible chez les adultes indiquant un moins bon état de santé par rapport aux adultes indiquant que leur état de santé est excellent. / Background: A majority of Canadians are physically inactive and have a sedentary lifestyle, which is an important risk factor for a variety of diseases. Recently, public health interventions have focused on active transport as means of increasing the level of activity in the population. Objective: This study’s aim is to quantify the direction and size of the association between self-rated health and active transport practices, i.e. utilitarian cycling and walking, among adult Montrealers. Methods: Data on physical activity and utilitarian practices were collected from 4503 adult residents of the Island of Montreal (≥ 18 years old), from one of two telephone surveys conducted in the spring and in the fall of 2009. Multiple logistic regression analysis was used to examine associations between self-rated health and utilitarian cycling (N=4386) and walking (N=4350). Results: Reporting a good and a fair/bad self-rated health was associated with a lower likelihood of practicing utilitarian walking (OR = 0,740; p < 0,05 and OR = 0,552; p < 0,01) than reporting an excellent health, but no significant association was found between self-rated health and utilitarian cycling in our study. Conclusions: Even though all results were not statistically significant, active transport practices appear to be less likely among persons reporting a poorer health in comparison to those reporting excellent health.

Measuring socioeconomic position (SEP) in population chronic disease and risk factor surveillance systems is essential for monitoring changes in socioeconomic inequities in health over time. A life course approach in epidemiology considers the long-term effects of physical and social exposures during gestation, childhood, adolescence, and later adult life on health. Previous studies provide evidence that socioeconomic factors at different stages of the life course influence current health status. Measures of SEP during early life to supplement existing indicators of current SEP are required to more adequately explain the contribution of socioeconomic factors to health status and monitor health inequities. The aim of this thesis was to examine how a life course perspective could enhance the monitoring of SEP in chronic disease and risk factor surveillance systems. The thesis reviewed indicators of early life SEP used in previous research, determined indicators of early life SEP that may be useful in South Australian surveillance systems, and examined the association of SEP over the life course and self-rated health in adulthood across different population groups to demonstrate that inclusion of indicators of early life SEP in surveillance systems could allow health inequities to be monitored among socially mobile and stable groups. A variety of indicators, such as parents’ education level and occupation, and financial circumstances and living conditions during childhood, have been used in different study designs in many countries. Indicators of early life SEP used to monitor trends in the health and SEP of populations over time, and to analyse long-term effects of policies on the changing health of populations, need to be feasible to measure retrospectively, and relevant to the historical, geographical and sociocultural context in which the surveillance system is operating. Retrospective recall of various indicators of early life SEP was examined in a telephone survey of a representative South Australian sample of adults. The highest proportions of missing data were observed for maternal grandfather’s occupation, and mother’s and father’s highest education level. Family structure, housing tenure, and family financial situation when the respondent was aged ten, and mother and father’s main occupation had lower item non-response. Respondents with missing data on early life SEP indicators were disadvantaged in terms of current SEP compared to those who provided this information. The differential response to early life SEP questions according to current circumstances has implications for chronic disease surveillance examining the life course impact of socioeconomic disadvantage. While face-to-face surveys are considered the gold standard of interviewing techniques, computer-assisted telephone interviewing is often preferred for cost and convenience. Recall of father’s and mother’s highest education level in the telephone survey was compared to that obtained in a face-to-face interview survey. The proportion of respondents who provided information about their father’s and mother’s highest education level was significantly higher in the face-to-face interview than in the telephone interview. Survey mode, however, did not influence the finding that respondents with missing data for parents’ education were more likely to be socioeconomically disadvantaged. Alternative indicators of early life SEP, such as material and financial circumstances, are likely to be more appropriate than parents’ education for life course analyses of health inequities using surveillance data. Questions about family financial situation and housing tenure during childhood and adulthood asked in the cross-sectional telephone survey were used to examine the association of SEP over the life course with self-rated health in adulthood. Disadvantaged SEP during both childhood and adulthood and upward social mobility in financial situation were associated with a reduced prevalence of excellent or very good health, although this relationship varied across gender, rurality, and country of birth groups. Trend data from a chronic disease and risk factor surveillance system indicated that socioeconomic disadvantage in adulthood was associated with poorer self-rated health. The surveillance system, however, does not currently contain any measures of early life SEP. Overlaying the social mobility variables on the surveillance data indicated how inequities in health could be differentiated in greater detail if early life SEP was measured in addition to current SEP. Inclusion of life course SEP measures in surveillance will enable monitoring of health inequities trends among socially mobile and stable groups. Life course measures are an innovative way to supplement other SEP indicators in surveillance systems. Considerable information can be gained with the addition of a few questions. This will provide further insight into the determinants of health and illness and enable improved monitoring of the effects of policies and interventions on health inequities and intergenerational disadvantage. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1367190 / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2009

Measuring socioeconomic position (SEP) in population chronic disease and risk factor surveillance systems is essential for monitoring changes in socioeconomic inequities in health over time. A life course approach in epidemiology considers the long-term effects of physical and social exposures during gestation, childhood, adolescence, and later adult life on health. Previous studies provide evidence that socioeconomic factors at different stages of the life course influence current health status. Measures of SEP during early life to supplement existing indicators of current SEP are required to more adequately explain the contribution of socioeconomic factors to health status and monitor health inequities. The aim of this thesis was to examine how a life course perspective could enhance the monitoring of SEP in chronic disease and risk factor surveillance systems. The thesis reviewed indicators of early life SEP used in previous research, determined indicators of early life SEP that may be useful in South Australian surveillance systems, and examined the association of SEP over the life course and self-rated health in adulthood across different population groups to demonstrate that inclusion of indicators of early life SEP in surveillance systems could allow health inequities to be monitored among socially mobile and stable groups. A variety of indicators, such as parents’ education level and occupation, and financial circumstances and living conditions during childhood, have been used in different study designs in many countries. Indicators of early life SEP used to monitor trends in the health and SEP of populations over time, and to analyse long-term effects of policies on the changing health of populations, need to be feasible to measure retrospectively, and relevant to the historical, geographical and sociocultural context in which the surveillance system is operating. Retrospective recall of various indicators of early life SEP was examined in a telephone survey of a representative South Australian sample of adults. The highest proportions of missing data were observed for maternal grandfather’s occupation, and mother’s and father’s highest education level. Family structure, housing tenure, and family financial situation when the respondent was aged ten, and mother and father’s main occupation had lower item non-response. Respondents with missing data on early life SEP indicators were disadvantaged in terms of current SEP compared to those who provided this information. The differential response to early life SEP questions according to current circumstances has implications for chronic disease surveillance examining the life course impact of socioeconomic disadvantage. While face-to-face surveys are considered the gold standard of interviewing techniques, computer-assisted telephone interviewing is often preferred for cost and convenience. Recall of father’s and mother’s highest education level in the telephone survey was compared to that obtained in a face-to-face interview survey. The proportion of respondents who provided information about their father’s and mother’s highest education level was significantly higher in the face-to-face interview than in the telephone interview. Survey mode, however, did not influence the finding that respondents with missing data for parents’ education were more likely to be socioeconomically disadvantaged. Alternative indicators of early life SEP, such as material and financial circumstances, are likely to be more appropriate than parents’ education for life course analyses of health inequities using surveillance data. Questions about family financial situation and housing tenure during childhood and adulthood asked in the cross-sectional telephone survey were used to examine the association of SEP over the life course with self-rated health in adulthood. Disadvantaged SEP during both childhood and adulthood and upward social mobility in financial situation were associated with a reduced prevalence of excellent or very good health, although this relationship varied across gender, rurality, and country of birth groups. Trend data from a chronic disease and risk factor surveillance system indicated that socioeconomic disadvantage in adulthood was associated with poorer self-rated health. The surveillance system, however, does not currently contain any measures of early life SEP. Overlaying the social mobility variables on the surveillance data indicated how inequities in health could be differentiated in greater detail if early life SEP was measured in addition to current SEP. Inclusion of life course SEP measures in surveillance will enable monitoring of health inequities trends among socially mobile and stable groups. Life course measures are an innovative way to supplement other SEP indicators in surveillance systems. Considerable information can be gained with the addition of a few questions. This will provide further insight into the determinants of health and illness and enable improved monitoring of the effects of policies and interventions on health inequities and intergenerational disadvantage. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1367190 / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2009

Measuring socioeconomic position (SEP) in population chronic disease and risk factor surveillance systems is essential for monitoring changes in socioeconomic inequities in health over time. A life course approach in epidemiology considers the long-term effects of physical and social exposures during gestation, childhood, adolescence, and later adult life on health. Previous studies provide evidence that socioeconomic factors at different stages of the life course influence current health status. Measures of SEP during early life to supplement existing indicators of current SEP are required to more adequately explain the contribution of socioeconomic factors to health status and monitor health inequities. The aim of this thesis was to examine how a life course perspective could enhance the monitoring of SEP in chronic disease and risk factor surveillance systems. The thesis reviewed indicators of early life SEP used in previous research, determined indicators of early life SEP that may be useful in South Australian surveillance systems, and examined the association of SEP over the life course and self-rated health in adulthood across different population groups to demonstrate that inclusion of indicators of early life SEP in surveillance systems could allow health inequities to be monitored among socially mobile and stable groups. A variety of indicators, such as parents’ education level and occupation, and financial circumstances and living conditions during childhood, have been used in different study designs in many countries. Indicators of early life SEP used to monitor trends in the health and SEP of populations over time, and to analyse long-term effects of policies on the changing health of populations, need to be feasible to measure retrospectively, and relevant to the historical, geographical and sociocultural context in which the surveillance system is operating. Retrospective recall of various indicators of early life SEP was examined in a telephone survey of a representative South Australian sample of adults. The highest proportions of missing data were observed for maternal grandfather’s occupation, and mother’s and father’s highest education level. Family structure, housing tenure, and family financial situation when the respondent was aged ten, and mother and father’s main occupation had lower item non-response. Respondents with missing data on early life SEP indicators were disadvantaged in terms of current SEP compared to those who provided this information. The differential response to early life SEP questions according to current circumstances has implications for chronic disease surveillance examining the life course impact of socioeconomic disadvantage. While face-to-face surveys are considered the gold standard of interviewing techniques, computer-assisted telephone interviewing is often preferred for cost and convenience. Recall of father’s and mother’s highest education level in the telephone survey was compared to that obtained in a face-to-face interview survey. The proportion of respondents who provided information about their father’s and mother’s highest education level was significantly higher in the face-to-face interview than in the telephone interview. Survey mode, however, did not influence the finding that respondents with missing data for parents’ education were more likely to be socioeconomically disadvantaged. Alternative indicators of early life SEP, such as material and financial circumstances, are likely to be more appropriate than parents’ education for life course analyses of health inequities using surveillance data. Questions about family financial situation and housing tenure during childhood and adulthood asked in the cross-sectional telephone survey were used to examine the association of SEP over the life course with self-rated health in adulthood. Disadvantaged SEP during both childhood and adulthood and upward social mobility in financial situation were associated with a reduced prevalence of excellent or very good health, although this relationship varied across gender, rurality, and country of birth groups. Trend data from a chronic disease and risk factor surveillance system indicated that socioeconomic disadvantage in adulthood was associated with poorer self-rated health. The surveillance system, however, does not currently contain any measures of early life SEP. Overlaying the social mobility variables on the surveillance data indicated how inequities in health could be differentiated in greater detail if early life SEP was measured in addition to current SEP. Inclusion of life course SEP measures in surveillance will enable monitoring of health inequities trends among socially mobile and stable groups. Life course measures are an innovative way to supplement other SEP indicators in surveillance systems. Considerable information can be gained with the addition of a few questions. This will provide further insight into the determinants of health and illness and enable improved monitoring of the effects of policies and interventions on health inequities and intergenerational disadvantage. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1367190 / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2009

A população mundial vem envelhecendo, diante dessa premissa a Organização Mundial de Saúde (OMS), bem como, o Ministério da Saúde (MS) do Brasil, vem buscando adaptar-se a esta realidade através de políticas públicas capazes de promover o envelhecimento ativo e da atenção à saúde adaptada às necessidades da população idosa. A OMS propôs a adequação da Atenção Primária à Saúde (APS) às necessidades dos idosos. O Brasil, por sua vez, segue as orientações da OMS, dentro da linha de cuidado voltada para a saúde dos idosos, na Estratégia de Saúde da Família e dentro da Política de Atenção à Saúde da Pessoa Idosa. No entanto, ainda não há evidências quanto à avaliação da adequação destas políticas e de sua relação com a forma como os idosos percebem sua saúde geral e bucal. Desta forma, esta pesquisa teve como objetivo verificar a extensão do cuidado em saúde que é acessado por idosos moradores de dois distritos de Porto Alegre/RS, em relação ao preconizado para efetividade da Atenção Primária à Saúde, e realizar um censo das unidades de saúde de APS dos mesmos distritos a fim de estabelecer uma relação entre os dados empíricos levantados e: i) Políticas de Saúde relacionadas com a Atenção Primária à Saúde voltadas às necessidades das pessoas idosas, ii) autoavaliação de saúde geral e iii) percepção de saúde bucal. A metodologia do estudo contou com um estudo teórico realizado através de um levantamento de documentos, um estudo epidemiológico de base populacional de delineamento transversal e um censo de unidades de saúde. Os resultados deste estudo apontam para uma realidade distinta entre o que as Políticas voltadas para os idosos preconizam e o que é oferecido para os idosos. Foram observadas limitações em relação ao acesso, longitudinalidade, integralidade e qualidade do cuidado. Além disso, foi possível observar que em relação à autoavaliação de saúde os resultados mostraram associações entre a avaliação positiva da saúde e fatores psicossociais (sintomatologia depressiva), características pessoais (nº de morbidades) e ambientais (orientação do serviço para a APS). Já em relação à percepção de saúde bucal, os resultados apontaram associação com determinantes primários (satisfação com último atendimento odontológico, resiliência e renda suficiente para as necessidades da família), comportamentos em saúde (hábito tabágico) e condições de saúde bucal (número de dentes e presença de restos radiculares). A conclusão que se chegou a partir de tais resultados é que há uma necessidade premente de ampliação do acesso e qualificação do cuidado para que a Atenção Primária disponibilizada para os idosos que vivem nos distritos Lomba do Pinheiro e Partenon em Porto Alegre possa ser realmente considerada adequada às necessidades dos idosos. Além disso, é necessário que se leve em consideração o papel da Atenção Primária a saúde na avaliação da sua própria saúde e na percepção de saúde bucal por parte de idosos. / The world population is aging. In response to those trends the World Health Organization (WHO), as well as the Brazilian Ministry of Health (MH), are aiming at tackling such matters through public policies that promote active aging through health care adapted to the needs of the elderly population. The WHO has proposed an Age-friendly Primary Health Care (PHC) that lies in accordance with the needs of the elderly. In Brazil, the WHO guidelines are followed within older people care provision, in the Family Health Strategy, and within the National Health Policy for the Elderly Person. However, there is still no evidence concerning the assessment of adequacy of these policies and its association with how older people perceive their general and oral health. Thus, this study aimed to verify the extension towards primary health care provided by health services accessed by older persons living in two sanitary districts of Porto Alegre/RS in relation with the recommendation in terms of effectiveness of primary health care. In addition, a census of the primary health care services of the two sanitary districts was carried out forming, along with the epidemiological survey, the basis of the empirical data that allowed establish a relationship with: i) Health Policies related to Primary Health Care and targeting on the needs of older persons, ii) self-rated health and iii) self-perceived oral health. The methodology included: theoretical study made by a documental research, a cross-sectional population-based epidemiological study and a health PHC services census. The results of this study show a distinct reality between what policies targeting older persons recommend and what is actually provided, limitations in terms of access, longitudinally, comprehensiveness and quality of care were observed. Furthermore, it was observed that positive self-rated health was associated with psychosocial factors (depressive symptomatology), personal characteristics (number of morbidities) and environmental characteristics (orientation towards PHC Attributes). Self-perceived oral health was associated with primary determinants of health (satisfaction with prior dental appointment, resilience and income that was enough to meet family needs), 17 health behaviors (smoking habit) and oral health status (number of teeth and of root remnants). Concluding, there is an urgent need to increase access and to qualify care so that Primary Health Care services made available for older people, at least for those who live in the Lomba do Pinheiro and Partenon sanitary districts of Porto Alegre/RS, reach its goals of providing adequate and resolutive care that is adequate to the needs of the elderly. Furthermore, it is necessary to take into account the role of Primary Health Care on the rate of health and perception of oral health by the elderly. Still, advances in relation to equity and quality of care in respect to primary health care professionals continued education attainment were observed.

A população mundial vem envelhecendo, diante dessa premissa a Organização Mundial de Saúde (OMS), bem como, o Ministério da Saúde (MS) do Brasil, vem buscando adaptar-se a esta realidade através de políticas públicas capazes de promover o envelhecimento ativo e da atenção à saúde adaptada às necessidades da população idosa. A OMS propôs a adequação da Atenção Primária à Saúde (APS) às necessidades dos idosos. O Brasil, por sua vez, segue as orientações da OMS, dentro da linha de cuidado voltada para a saúde dos idosos, na Estratégia de Saúde da Família e dentro da Política de Atenção à Saúde da Pessoa Idosa. No entanto, ainda não há evidências quanto à avaliação da adequação destas políticas e de sua relação com a forma como os idosos percebem sua saúde geral e bucal. Desta forma, esta pesquisa teve como objetivo verificar a extensão do cuidado em saúde que é acessado por idosos moradores de dois distritos de Porto Alegre/RS, em relação ao preconizado para efetividade da Atenção Primária à Saúde, e realizar um censo das unidades de saúde de APS dos mesmos distritos a fim de estabelecer uma relação entre os dados empíricos levantados e: i) Políticas de Saúde relacionadas com a Atenção Primária à Saúde voltadas às necessidades das pessoas idosas, ii) autoavaliação de saúde geral e iii) percepção de saúde bucal. A metodologia do estudo contou com um estudo teórico realizado através de um levantamento de documentos, um estudo epidemiológico de base populacional de delineamento transversal e um censo de unidades de saúde. Os resultados deste estudo apontam para uma realidade distinta entre o que as Políticas voltadas para os idosos preconizam e o que é oferecido para os idosos. Foram observadas limitações em relação ao acesso, longitudinalidade, integralidade e qualidade do cuidado. Além disso, foi possível observar que em relação à autoavaliação de saúde os resultados mostraram associações entre a avaliação positiva da saúde e fatores psicossociais (sintomatologia depressiva), características pessoais (nº de morbidades) e ambientais (orientação do serviço para a APS). Já em relação à percepção de saúde bucal, os resultados apontaram associação com determinantes primários (satisfação com último atendimento odontológico, resiliência e renda suficiente para as necessidades da família), comportamentos em saúde (hábito tabágico) e condições de saúde bucal (número de dentes e presença de restos radiculares). A conclusão que se chegou a partir de tais resultados é que há uma necessidade premente de ampliação do acesso e qualificação do cuidado para que a Atenção Primária disponibilizada para os idosos que vivem nos distritos Lomba do Pinheiro e Partenon em Porto Alegre possa ser realmente considerada adequada às necessidades dos idosos. Além disso, é necessário que se leve em consideração o papel da Atenção Primária a saúde na avaliação da sua própria saúde e na percepção de saúde bucal por parte de idosos. / The world population is aging. In response to those trends the World Health Organization (WHO), as well as the Brazilian Ministry of Health (MH), are aiming at tackling such matters through public policies that promote active aging through health care adapted to the needs of the elderly population. The WHO has proposed an Age-friendly Primary Health Care (PHC) that lies in accordance with the needs of the elderly. In Brazil, the WHO guidelines are followed within older people care provision, in the Family Health Strategy, and within the National Health Policy for the Elderly Person. However, there is still no evidence concerning the assessment of adequacy of these policies and its association with how older people perceive their general and oral health. Thus, this study aimed to verify the extension towards primary health care provided by health services accessed by older persons living in two sanitary districts of Porto Alegre/RS in relation with the recommendation in terms of effectiveness of primary health care. In addition, a census of the primary health care services of the two sanitary districts was carried out forming, along with the epidemiological survey, the basis of the empirical data that allowed establish a relationship with: i) Health Policies related to Primary Health Care and targeting on the needs of older persons, ii) self-rated health and iii) self-perceived oral health. The methodology included: theoretical study made by a documental research, a cross-sectional population-based epidemiological study and a health PHC services census. The results of this study show a distinct reality between what policies targeting older persons recommend and what is actually provided, limitations in terms of access, longitudinally, comprehensiveness and quality of care were observed. Furthermore, it was observed that positive self-rated health was associated with psychosocial factors (depressive symptomatology), personal characteristics (number of morbidities) and environmental characteristics (orientation towards PHC Attributes). Self-perceived oral health was associated with primary determinants of health (satisfaction with prior dental appointment, resilience and income that was enough to meet family needs), 17 health behaviors (smoking habit) and oral health status (number of teeth and of root remnants). Concluding, there is an urgent need to increase access and to qualify care so that Primary Health Care services made available for older people, at least for those who live in the Lomba do Pinheiro and Partenon sanitary districts of Porto Alegre/RS, reach its goals of providing adequate and resolutive care that is adequate to the needs of the elderly. Furthermore, it is necessary to take into account the role of Primary Health Care on the rate of health and perception of oral health by the elderly. Still, advances in relation to equity and quality of care in respect to primary health care professionals continued education attainment were observed.