Mensuração de desigualdades sociais em saúde: conceitos e abordagens metodológicas no contexto brasileiro*

Abstract

This study aims to describe methodological approaches to measure and monitor health inequalities and to illustrate their applicability. The measures most frequently used in the literature were reviewed. Data on coverage and quality of antenatal care in Brazil, from the Demographic and Maternal and Child Health Survey (PNDS-2006) and from the National Health Survey (PNS-2013), were used to illustrate their applicability. Absolute and relative measures of inequalities were presented, highlighting their complementary character. Despite the progress achieved at national level in antenatal care, important inequalities were still identified between population subgroups, with no change in the magnitude of the differences throughout the studied period. Brazil has important social inequalities, which consequently lead to health inequalities. Their description and monitoring are highly relevant to support polices focused on those vulnerable population groups who have been left behind.

Evolução das desigualdades socioeconômicas na realização de consultas de pré-natal entre parturientes brasileiras: análise do período 2000-2015*

“…Each one has a different and complementary type of information and both of them are of great relevance for researchers and planners. 29 Relative inequality is quite sensitive to the frequency of the occurrence of the outcome and, with the substantial increase in coverage, there may, for example, be a reduction in relative inequality and an increase in absolute inequality. Therefore, it is always advisable to use both measures when analyzing health inequalities.…”

Integration of Facility Location and Equipment Allocation in Health Care Management

“…The journal remarks upon the growth in works approaching the public health that results in advances based on scientific actions. Studies show, for example, the relation between social and health inequality that contributes to guiding interventions and actions on public policies (Silva et. al, 2018).…”

Iniquidades do ambiente construído relacionado à atividade física no entorno de escolas públicas de Curitiba, Paraná, Brasil

“…Inequalities in health refer to the observable differences between subgroups within a population 5 . Meanwhile, iniquities are inequalities that are considered unfair and amenable to being avoided 5 , the effort at which is the focus of public policies in health 6 . One global topic that underlines initiatives to fight health iniquities in cities is the need to deal with situations where, even in cities with abundant resources, the opportunities are concentrated in a small and select group of individuals 2 .…”

“…En el análisis bruto, la mayor variabilidad entre las escuelas se observó en la sección Segmentos (ICC = 0,41), y la menor, en la sección Rutas (ICC = 0,19). Los segmentos de calle, localizados en el entorno de escuelas del primer tercil de renta, alcanzaron una media ajustada de 15,6 (IC95%: 13,[0][1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]3) en el marcador total, casi la mitad de aquellos de renta mayor, que alcanzaron 30,7 (IC95%: 28,5) puntos, con diferencia significativa entre los terciles (p < 0,001). El marcador de las áreas más centrales fue 30,1 (IC95%: 26,4), significativamente mayor (p < 0,001), si se compara a aquellas más periféricas, donde la puntuación fue 16,3 (IC95%: 12,[8][9][10][11][12][13][14][15][16][17][18][19]8).…”