The urban environment from the health perspective: the case of Belo Horizonte, Minas Gerais, Brazil

Abstract

This study aims to determine spatial patterns of mortality and morbidity for five health problems in an urban environment: homicides, adolescent pregnancy, asthma hospitalization, and two vector-borne diseases, dengue and visceral leishmaniasis. All events were obtained through the city health database and geoprocessed using residential addresses and 80 planning units consisting of census tracts. We used thematic maps, proportionate mortality/morbidity ratios by planning unit, and the overlapped rank of the 20th worse planning unit rates for each event. A spatial pattern of high rates of homicides, proportion of young mothers, and hospitalization due to asthma overlapped in socially and economically disadvantaged areas. For the two vector-borne diseases, high rates with great dispersion were found in underprivileged areas, in contrast with very low rates among higher income areas. The results indicated the coexistence of heavier disease burden for residents of urban areas where poverty and lack of effective public health policies may be modulating social health problems. For the two vector-borne diseases, an environmental intervention in one mosquito-borne disease might be playing a role in the other's incidence.

Tendência da mortalidade por homicídios em Belo Horizonte e região metropolitana: 1980-2005

“…According to Barros et al, 2 the predominance of males in homicide mortality is related to their greater exposure to potential risk factors like alcohol consumption, use of licit and illicit drugs and use of fi re weapons. According to Caiaffa et al, 4 the homicide mortality rates in the metropolitan area have presented greater increases in relation to the municipality of Belo Horizonte.…”

“…According to the authors, the process of occupying urban areas and the social inequalities in Brazilian municipalities are risk factors for violence. Caiaffa et al, 4 based on data related to the municipality of Belo Horizonte, also associated violence in the large cities with inequalities in urban living conditions, low socioeconomic indicators and worse access to the benefi ts of social services. Ishitani et al, 10 in their analysis of mortality differences in urban areas in the 1990s, in Belo Horizonte and the metropolitan area, identifi ed that living in favelas was associated with higher rates of homicide mortality, independent of sex and age.…”

“…These circumstances decrease opportunities for personal and professional growth and therefore restrict their rights as citizens. 4,22 The unavailability of information on potential risk or protective factors for homicide mortality over long time series, limits the investigation of their infl uence upon the outcomes, prohibiting causal inferences even in an ecological basis. Nonetheless, it can be inferred that the economic crisis, which began in Brazil in the beginning of the 1980s, when the formal job market went into recession, is a possible explanation for the increasing trend of the indicators in subsequent years due to the increase in underemployment and unemployment, which contributed to increasing the amount of people in misery.…”

Distribuição espaço-temporal dos candidatos à doação de sangue da Fundação Hemominas, Belo Horizonte, Minas Gerais, Brasil, nos anos de 1994 e 2004

“…Muitos destes estudos trabalham com eventos na forma de processos pontuais 11,12,13,14,15 , outros analisam os eventos na forma de taxas 16,17,18,19,20,21 . O uso dessas técnicas permite um melhor entendimento da dinâmica dos eventos relacionados à saúde no espaço, auxiliando na elaboração de políticas e programas de saúde.…”

“…Em estudo de 2004, Moran et al 16 utilizaram taxas padronizadas de doadores de sangue no Reino Unido como medida do capital social para pequenas áreas. Os autores incluíram o espaço na modelagem multi-nível e correlacionaram essas taxas com variáveis epidemiológicas e sociais.…”