São Paulo urban health index: measuring and mapping health disparities

Abstract

Objective: To calculate and map the health inequalities in the city of São Paulo using the Urban Health Index (UHI) methodology. Methods: Seven indicators were selected from the Brazilian census: (1) proportion of households with access to sewage systems, (2) proportion of households served by regular waste collection, (3) proportion of households with two or more toilets, (4) proportion of households receiving tap water, (5) average income per household, (6) percentage of white people, and (7) literacy rate. Based on the UHI methodology, all health indicators were standardized and aggregated into a single metric at the census tract level. The UHI scores were ranked and plotted. The disparity ratio and the graph slope were calculated. The correlation between indicators was tested. Results were geocoded to produce a map of health risks. Results: The distribution of index values showed a linear middle section and deviations at each end. The disparity ratio found was 2.95, while the slope was 0.30. All indicators were significantly correlated. The map displayed a typical pattern of health inequality between the downtown and the periphery. The tracts located in the city’s downtown had higher UHI values than those on the outskirts. Conclusions: The results of this study presented a visual distribution of health disparities in the city of São Paulo, proving to be a valuable method for identifying areas that require public health attention.

The Rise of Gastrointestinal Cancers as a Global Phenomenon: Unhealthy Behavior or Progress?

“…Apart from exposure to environmental factors, disparities in risk, prognosis, and survival of patients with GI cancers may depend much more on socioeconomic status (for example, access to prevention, vaccination, and early diagnosis) than on genetic or geographic risk factors [ 26 ]. Similarly, reducing health inequalities poses a challenge to most nations, where social determinants of health, from diet to access to screening, diagnosis, and proper treatment, differ considerably [ 27 ]. Understanding the disease risk and mortality of digestive cancers requires more than looking for genetic inheritance or individual habits, but very importantly, taking into account social, economic, cultural, and psychological circumstances that determine lifestyle and exposure to risk factors during all phases of life [ 28 ].…”