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.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/24606 |
| Date | 31 August 2017 |
| Creators | Gomes, Lillian Karielly de Ara?jo |
| Contributors | 07123213491, Costa, Nilma Dias Le?o, 13053434415, Paes, Neir Antunes, 09363653404, Formiga, Maria C?lia de Carvalho |
| Publisher | PROGRAMA DE P?S-GRADUA??O EM DEMOGRAFIA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
Page generated in 0.002 seconds