Inequalities in healthy life expectancy by Brazilian geographic regions: findings from the National Health Survey, 2013

Szwarcwald, Célia Landmann; Júnior, Paulo Roberto Borges de Souza; Marques, Aline; Almeida, Wanessa da Silva de; Romero, Dália Elena

doi:10.1186/s12939-016-0432-7

Cited by 86 publications

(92 citation statements)

References 54 publications

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“…In addition to socioeconomic inequality, other existing forms of inequality in Brazil can also influence the outcomes related to breast cancer. Moreover, all these factors contribute to increased rates of smoking, physical inactivity, excessive alcohol consumption, and overweight, which are risk factors for chronic diseases and are also related to breast cancer . In this context, from a public health point of view, it is important to know which of these factors are associated with the incidence and mortality of such disease.…”

Section: Correlation Of Variables With Indicators Of Breast Cancer Inmentioning

confidence: 99%

Risk factors for breast cancer mortality: Evidence from Brazil

et al. 2018

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Breast cancer remains the leading type of cancer in women globally and accounts for 25% of all cancer cases diagnosed. It results in approximately half a million deaths and approximate loss of 15 million disability-adjusted life years. 1 In Brazil, where its incidence increases by 1.8 cases per 100 000 inhabitants per year, 2 existing socioeconomic inequality greatly influences the early diagnosis and prevention of breast cancer, 3 thereby, creating a great challenge to the public health services focusing on the disease.In addition to socioeconomic inequality, other existing forms of inequality in Brazil 4 can also influence the outcomes related to breast cancer. Moreover, all these factors contribute to increased rates of smoking, physical inactivity, excessive alcohol consumption, and overweight, which are risk factors for chronic diseases and are also related to breast cancer. 5 In this context, from a public health point of view, it is important to know which of these factors are associated with the incidence and mortality of such disease.Thus, we performed an ecological study analyzing secondary data obtained from the Department of Information Technology of SUS (DATASUS) and the United Nations Development Program (UNDP). The units of analysis were the years between 2006 and 2014. Deaths and hospital admissions for breast cancer in women were collected from the Mortality Information System and Hospital Information System (HIS), respectively. Both are available for public access in the Department of Information Technology of the Brazilian Unified Health System (SUS), maintained by the Brazilian Ministry of Health. Hospital admission and mortality rates were estimated by 100 000 women and age-standardized by age according to the World Health Organization by the direct method. After univariate analysis of the Pearson's correlation, a multiple linear regression was performed, adopting the stepwise backward strategy, using the criteria for the withdrawal of P > 0.20 model. The level of significance was 5%. The program used was Stata® (Stata Corp., College Station, TX, USA) 11.0. The main results found were that between 2006 and 2014, overweight, average cost of hospital admission, number of available SUS mammographs, and the HDI were the main factors that influenced the mortality and hospital admission rate of breast cancer in Brazil (Table 1). The model that analyzes the socioeconomic aspects presented better explanatory capacity (r 2 = 0.99) than the models related to T A B L E 1 Correlation of variables with indicators of breast cancer in Brazil Indicator Mortality a Hospital admission rate a r P b r P b Lifestyle Overweight women rate 0.927 <0.001 0.807 0.008 Rate of physically inactive women 0.422 0.257 0.317 0.405 Rate of women with alcohol abuse 0.204 0.597 0.069 0.859 Excessive smoking rate among women −0.698 0.036 −0.669 0.048 Health service Doctors c 0.979 <0.001 0.864 0.002 Beds c −0.935 0.002 −0.871 0.010 Mammographs in SUS c 0.959 <0.001 0.878 0.002 Socioeconomic Human development index 0.994 <0.001 0...

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Section: Correlation Of Variables With Indicators Of Breast Cancer Inmentioning

confidence: 99%

Risk factors for breast cancer mortality: Evidence from Brazil

et al. 2018

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“…In terms of health status, the edition includes an article on regional disparities in healthy life expectancy by Szwarcwald et al [5] and an article by Barros et al [6] which assesses inequalities in several health behaviors associated with risk of chronic conditions.…”

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confidence: 99%

A panorama of health inequalities in Brazil

Landmann-Szwarcwald

Macinko

2016

Int J Equity Health

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“…Despite being higher than expected, the poor performance in this region was likely due to the reduced rate of healthcare services utilization . Individuals from the North and Northeast regions suffer with lower educational attainment, income and have a lower life expectancy at birth . More than 50% of the Amazonian population still lack primary healthcare coverage…”

Section: Discussionmentioning

confidence: 99%

Inequity in utilizing health services in the Brazilian Amazon: A population‐based survey, 2015

Galvão

Tiguman

Caicedo-Roa

et al. 2019

Health Planning & Management

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Summary Background Although Brazil has a public and universal healthcare system, utilization of health services is marked by social and regional discrepancies. Objective To assess the prevalence and factors associated with underutilization of healthcare services in the Brazilian Amazon. Method Cross‐sectional, population‐based study. Adults aged over 18 years old were selected through probabilistic sampling. Underutilization of healthcare services was defined as never seeing a physician or a dentist. Poisson regression with robust variance was performed to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs). A complex sample design was considered. Results A total of 4001 individuals were included, of which 419 (10.4%; 95% CI, 9.5‐11.4%) never visited a physician or a dentist. In the adjusted analysis, underutilization was higher among poorer people (PR = 3.32; 95% CI, 2.16‐5.11), men (PR = 1.34; 95% CI, 1.10‐1.65), people with brown skin color (Brazilian mixed race; PR = 1.34; 95% CI, 1.02‐1.76), and people who are separated (PR = 1.40; 95% CI, 1.01‐1.94) and widowed (PR = 1.55; 95% CI, 1.02‐2.37), when compared with the reference categories. Individuals with informal jobs, those who are retired, students/housewives, and unemployed people were more vulnerable to underutilization than formal workers (P < .04). Conclusion Underutilization of healthcare services occurs in one‐tenth of adults in Manaus Metropolitan Region and is associated with social and economic inequities.

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Inequalities in healthy life expectancy by Brazilian geographic regions: findings from the National Health Survey, 2013

Cited by 86 publications

References 54 publications

Risk factors for breast cancer mortality: Evidence from Brazil

Risk factors for breast cancer mortality: Evidence from Brazil

A panorama of health inequalities in Brazil

Inequity in utilizing health services in the Brazilian Amazon: A population‐based survey, 2015

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