Influência da densidade de tráfego veicular na internação por câncer do aparelho respiratório no Município de São Paulo, Brasil

et al. 2020

Preprint

Background: The National Policy of Comprehensive Women’s Health Care was implemented more than two decades ago, and the monitoring of potential benefits should be explored. Menopause is a period of life for which there are prevention and health promotion actions carried out by the government’s all-encompassing sole Unify Health System (UHS) and factored into Brazilian policies. It is thus our purpose to identify menopausal women’s main causes of death, as well as the mortality trend of such causes, especially after PNAISM implementation. Methods: This is an ecological study with secondary data analysis conducted by the Setor de Atenção Primária, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo from 2018 to 2019. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the IT Department of SUS between 1996 and 2016, divided in two periods 1996 to 2004 and 2005 to 2006 according to implementation of the National Police. The data included the death records of Brazilian women aged 35 to 64 years who had a precise diagnosis (ICD-10). Trend and differences between periods were evaluated by linear regression. The significance level was set at 5%. Stata 11® (StataCorp, LCC) was used. Results: Menopausal women’s main causes of death were the circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine (29.39%), nutritional, and metabolic (6.81%, 170,881 deaths) diseases, and external causes of morbidity and mortality (5.49%, 137,674 deaths). Implementation of PNAISM led to increasing reduction in mortality from circulatory system diseases (β=-0.58; 95% CI, -0.68 to -0.48; r²=0.93; p<0.001), but not to any significant changes in neoplasm mortalities (β=0.07; 95% CI, -0.01 to 0.15; r²=0.22; p=0.070). Conclusions: The leading causes of death among menopausal women are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality. The trend of mortality rates among menopausal women, following PNAISM implementation, was a decline in circulatory system diseases and in nutritional, metabolic, and endocrine diseases, with no changes for neoplasms and respiratory system diseases.

Section: Discussionmentioning

confidence: 99%

National Policy of Comprehensive Women’s Health Care and Mortality in Menopause: Has Anything Changed?

et al. 2020

Preprint

“…The implementation success of other public policies, such as that of smoking, 32 could have changed the outcome. However, it is worth highlighting that, despite the studies 33,34 which demonstrate the harmful effects of environmental pollution, the behavioral changes in our women, who have been smoking less in the past decades, and the smoking cessation campaigns, mortality from respiratory diseases has not decreased.…”

Section: Discussionmentioning

confidence: 99%

Brazilian National Policy of Comprehensive Women’s Health Care and Mortality in Menopause: Has Anything Changed?

et al. 2020

Preprint

Background: The National Policy for Integral Attention to Women’s Health was implemented more than two decades ago, and the monitoring of potential benefits should be explored. One of the life cycles of women contemplated in this health policy is the importance of health care during the climacteric. In fact, prevention and health promotion actions carried out by the Brazil National Health System - Unified Health System (SUS) and enshrined in health Brazilian policies for women. Thus, our purpose is to identify menopausal women’s main causes of death, as well as the mortality trend of such causes, especially after PNAISM implementation.Methods: Ecological study conducted by Disciplina de Ginecologia da Faculdade de Medicina da Universidade de São Paulo from 2018 to 2019. Data were retrieved from Brazilian Health Department by accessing the mortality information system of National Health Information, divided in periods 1996-2004 and 2005-2006 according to implementation of the National Police. The death records of Brazilian women aged 35 to 64 years who had a diagnosis (ICD-10). Trend and differences between periods were evaluated by linear regression. The significance level was 5%. (Stata 11® -StataCorp, LCC). Results: Main causes of women’s death were the circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine (29.39%), nutritional, and metabolic (6.81%, 170,881 deaths) diseases, and external causes of morbidity and mortality (5.49%, 137,674 deaths). Implementation of PNAISM led to increasing reduction in mortality from circulatory system diseases (β=-0.58; 95% CI, -0.68 to -0.48; r²=0.93; p<0.001), and any significant changes in neoplasm mortalities (β=0.07; 95% CI, -0.01 to 0.15; r²=0.22; p=0.070). Conclusions: The leading causes of death during climacteric are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality, with no changes for neoplasms and respiratory system diseases. Thus, the analysis of women's health indicators, such as mortality rates, are fundamental in order to enable the monitoring of benefits and results related to PNAISM as well as directing the design and implementation of other new health policies to be developed for the women.

“…31 There was no reduction in deaths from respiratory diseases, a nding also shown in the results of Schmitt et al 8 The implementation success of other public policies, such as that of smoking, 32 could have changed the outcome. However, it is worth highlighting that, despite the studies, 33,34 which demonstrate the harmful effects of environmental pollution, the behavioral changes in women who have been smoking less in the past decades, and the promotion of smoking cessation campaigns, mortality from respiratory diseases has not decreased.…”

Section: Discussionmentioning

confidence: 99%

Brazilian National Policy of Comprehensive Women’s Health Care and Mortality during Climacteric Period: Has Anything Changed?

et al. 2020

Preprint

Background: The National Policy for Integral Attention to Women’s Health was implemented more than two decades ago, with the monitoring of potential benefits being explored. One of the life cycles of women contemplated in this health policy is the importance of health care during the climacteric. Prevention and health promotion actions carried out by the Brazil National Health System - Unified Health System and enshrined in health Brazilian policies for women. Thus, our purpose was to identify climacteric women’s main causes of death as well as the mortality trend of such causes, especially after PNAISM implementation. Methods: An ecological study was conducted by Disciplina de Ginecologia da Faculdade de Medicina da Universidade de São Paulo from 2018–2019. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the National Health Information, divided into periods 1996–2004 and 2005–2006 according to implementation of the National Police. The death records of Brazilian women aged 35 to 64 years who had a diagnosis were retrieved. Trends and differences between periods were evaluated using linear regression. The significance level was set at 5%. Results: The main causes of death in women were circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine , nutritional and metabolic diseases (6.81%, 170,881 deaths), and external causes of morbidity and mortality (5.49%, 137,674 deaths). Implementation of PNAISM led to a further reduction in mortality from circulatory system diseases (β=-0.58; 95% CI, -0.68 to -0.48; r²=0.93; p<0.001), and any significant changes in neoplasm mortality (β=0.07; 95% CI, -0.01. 0.15; r²=0.22; p=0.070). Conclusions: The leading causes of death during climacteric are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality, with no changes in neoplasms and respiratory system diseases. Thus, the analysis of women’s health indicators, such as mortality rates, is fundamental in order to enable the monitoring of benefits and results related to PNAISM as well as directing the design and implementation of other new health policies to be developed for women.