Agradeço a minha mãe por ser meu maior exemplo de caráter e dignidade. Ao meu irmão, Ramon, por todo apoio que me deu, à toda minha família por representar tudo de mais importante que tenho na vida e sempre ter me dado o suporte necessário para a conclusão do mestrado. Ao meu orientador, professor João Martines, por toda ajuda, paciência e conselhos que me deu ao longo tanto ao longo das disciplinas quanto na escrita da dissertação. Ao Dairy Partners Americas, joint venture entre a Nestlé e a Fonterra no Brasil, pelo fornecimento dos dados utilizados no trabalho, em especial à Janaína Giordani por todo apoio que me forneceu e Wellington, Fernanda, Bárbara e Igor pela coleta dos dados. Ao CNPq e a Capes pelo apoio financeiro que me foi concedido durante o curso. Ao professor Jan Grenz que me ajudou a compreender melhor a metodologia RISE e sempre esteve disponível para solucionar minhas dúvidas. Ao Michael Schoch pelo treinamento para aplicação dos questionários. Aos professores Ademar Romeiro, Thiago Romanelli e Daniela Bachi, que participaram das bancas, por todas sugestões e ideias para melhorar a dissertação. Ao casal, Daiana Schimidt e Marcelo Moraes, pelas conversas, risadas e dicas que me deram durante o convívio. A todos os amigos da turma de mestrado de 2011, do Programa de Pós Graduação em Economia Aplicada da Esalq-USP, que me ajudaram durante as disciplinas do curso e com as várias conversas sobre a dissertação, em especial agradeço à Karina Ferracioli, Kellen Rocha, Aniela Carrara e Valéria Pugeti. Agradeço também a todos os demais colegas da PPGEA tanto do mestrado quanto do doutorado que contribuíram de alguma forma durante essa fase.
Background: Over recent decades, Brazil’s health indicators have improved; however, access to the country’s health services is not homogeneous, with urban areas being better served than rural areas. The general objective of this work is to identify the influence of rural residence and other factors on the incidence of chronic spine problems, hypertension, and elevated levels of cholesterol in Brazil using the last Brazilian National Health Survey (NHS - 2013)) definitions and data. The analysis provided by this study contributes data that can be used to determine the probability of these three conditions occurring in Brazil and identifies the most vulnerable rural groups as defined by diet, physical activity, smoking, and alcohol consumption. Method: A logit model was estimated to identify the influence of the variables rural residence, sex, age, race, education, health insurance, work, Body Mass Index (BMI), consumption habits, and region of residence on the chronic conditions analyzed. Results: Results show that rural residents are 5.8% more likely to have chronic spine problems and 0.9% less likely to have hypertension than urban residents. The incidence of all conditions was lower in men than women. The Body Mass Index (BMI) value also influences the chance of having the conditions studied. Individuals with at least a secondary education were less affected by the analyzed conditions than those less educated. There were regional differences in these conditions’ incidence, mainly chronic spine problems and hypertension. Conclusions: The variables BMI, gender, and years of alcohol consumption had significance in all diseases analyzed. To correct underreporting issues, public policies should be directed to expand rural health services. Additionally, actions should be taken to raise the public's awareness of the effects of obesity and alcohol consumption on health.
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