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Previous issue date: 2015-08-14 / Esta pesquisa teve como objetivo analisar o efeito de diferentes divis?es territoriais na flutua??o aleat?ria de indicadores socioecon?micos relacionados ? determina??o social da sa?de. Trata-se de um estudo ecol?gico, com manipula??o de cinco bancos de dados oriundos da base de informa??es do censo demogr?fico brasileiro 2010 - Resultados gerais da amostra. Estes dados foram agrupados nos seguintes n?veis: Domic?lios; ?reas de Pondera??o; Munic?pios; Regi?es Imediatas de Articula??o Urbana e Regi?es Intermedi?rias de Articula??o Urbana. Foi utilizado um modelo te?rico relacionado ? determina??o social da sa?de, tendo como vari?vel dependente Domic?lio com ?bitos e como vari?veis independentes: Ra?a; Renda; Frequ?ncia ? escola ou creche; Analfabetismo; e Escolaridade baixa. Os dados foram analisados atrav?s da estat?stica descritiva e inferencial, utilizando regress?es de Poisson de base individual, regress?o multin?vel de Poisson e regress?es lineares m?ltiplas, ? luz do referencial te?rico da ?rea. Identificou-se uma maior propor??o de domic?lios com ?bitos dentre aqueles com pelo menos um morador preto, de menor renda, analfabeto, que n?o frequenta ou frequentou escola e creche e menos escolarizado. A an?lise do modelo ajustado demonstrou que a vari?vel Renda obteve a maior raz?o de preval?ncia, sendo observado um valor de risco de 1,33 para domic?lios com pelo menos um morador com renda m?dia menor que R$ 655,00. A an?lise multin?vel identificou a exist?ncia de efeitos de contexto, na medida em que os efeitos rand?micos foram significativos em todos os modelos e com raz?es de preval?ncia diferentes, sendo maiores nas ?reas com menores dimens?es - ?reas de Pondera??o, com ? de 0,035 e Munic?pios, com ? de 0,024. As an?lises lineares m?ltiplas demonstraram que as vari?veis Renda e Escolaridade baixa apresentaram potencial explicativo para o desfecho em todos os modelos, tendo a Renda um maior poder de determina??o dos ?bitos domiciliares, especialmente nos modelos relacionados ?s Regi?es Imediatas de Articula??o Urbana, com um coeficiente padronizado de -0,616 e Regi?es Intermedi?rias de Articula??o Urbana, com um coeficiente padronizado de -0,618. Conclui-se que ocorreu um efeito de contexto sobre a flutua??o aleat?ria dos indicadores socioecon?micos relacionados ? determina??o social da sa?de. Este efeito foi explicado pelas caracter?sticas das divis?es territoriais e dos indiv?duos que ali vivem ou trabalham. Os efeitos de contexto foram mais bem identificados nas ?reas com dimens?es menores, sendo estas mais favor?veis para explica??o de fen?menos relacionados ? determina??o social da sa?de, especialmente em estudos de sociedades marcadas pelas desigualdades sociais. Os efeitos de composi??o foram mais bem identificados nas regi?es de articula??o urbana, conformadas atrav?s de mecanismos semelhantes aos do fen?meno em estudo. / This research aimed to analyse the effect of different territorial divisions in the random fluctuation of socio-economic indicators related to social determinants of health. This is an ecological study resulting from a combination of statistical methods including individuated and aggregate data analysis, using five databases derived from the database of the Brazilian demographic census 2010: overall results of the sample by weighting area. These data were grouped into the following levels: households; weighting areas; cities; Immediate Urban Associated Regions and Intermediate Urban Associated Regions. A theoretical model related to social determinants of health was used, with the dependent variable Household with death and as independent variables: Black race; Income; Childcare and school no attendance; Illiteracy; and Low schooling. The data was analysed in a model related to social determinants of health, using Poisson regression in individual basis, multilevel Poisson regression and multiple linear regression in light of the theoretical framework of the area. It was identified a greater proportion of households with deaths among those with at least one black resident, lower-income, illiterate, who do not attend or attended school or day-care and less educated. The analysis of the adjusted model showed that most adjusted prevalence ratio was related to Income, where there is a risk value of 1.33 for households with at least one resident with lower average personal income to R$ 655,00 (Brazilian current). The multilevel analysis demonstrated that there was a context effect when the variables were subjected to the effects of areas, insofar as the random effects were significant for all models and with different prevalence rates being higher in the areas with smaller dimensions - Weighting areas with coefficient of 0.035 and Cities with coefficient of 0.024. The ecological analyses have shown that the variable Income and Low schooling presented explanatory potential for the outcome on all models, having income greater power to determine the household deaths, especially in models related to Immediate Urban Associated Regions with a standardized coefficient of -0.616 and regions intermediate urban associated regions with a standardized coefficient of -0.618. It was concluded that there was a context effect on the random fluctuation of the socioeconomic indicators related to social determinants of health. This effect was explained by the characteristics of territorial divisions and individuals who live or work there. Context effects were better identified in the areas with smaller dimensions, which are more favourable to explain phenomena related to social determinants of health, especially in studies of societies marked by social inequalities. The composition effects were better identified in the Regions of Urban Articulation, shaped through mechanisms similar to the phenomenon under study.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/21209 |
| Date | 14 August 2015 |
| Creators | Leite, Maria Jalila Vieira de Figueiredo |
| Contributors | 42313384420, http://lattes.cnpq.br/0023445563721084, Barcellos, Christovam de Castro, 85153451704, Souza, Dami?o Ernane de, 79881122449, http://lattes.cnpq.br/1932273466740095, Souza, Dyego Leandro Bezerra de, 00902557475, http://lattes.cnpq.br/9953301230987878, Ferreira, Maria Angela Fernandes, 39817270459, http://lattes.cnpq.br/4036539286429296, Oliveira, Angelo Giuseppe Roncalli da Costa |
| Publisher | Universidade Federal do Rio Grande do Norte, PROGRAMA DE P?S-GRADUA??O EM SA?DE COLETIVA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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