Social inequalities in health in two cities of São Paulo State: measurement, monitoring and analysis

• Grant number: 17/23995-9
• Support Opportunities: Research Projects - Thematic Grants
• Start date: February 01, 2019
• End date: January 31, 2025
• Field of knowledge: Health Sciences - Collective Health - Public Health
• Principal Investigator: Marilisa Berti de Azevedo Barros
• Grantee: Marilisa Berti de Azevedo Barros
• Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil
• Pesquisadores principais: Chester Luiz Galvão Cesar ; Moisés Goldbaum
• Associated researchers: Ana Paula Belon Lima ; Camila Nascimento Monteiro ; Carlos Castillo-Salgado ; Chester Luiz Galvão Cesar ; Ivan Dario Arroyave Zuluaga ; Karen Sarmento Costa ; Katia Cristina Bassichetto ; Margareth Guimarães Lima ; Margarida Maria Tenório de Azevedo Lira ; Maria Cecilia Goi Porto Alves ; Maria Mercedes Loureiro Escuder ; Marielle A Beenackers ; Marilia Cristina Prado Louvison ; Moisés Goldbaum ; Neuber José Segri ; Regina Mara Fisberg ; Shamyr Sulyvan de Castro ; Tássia Fraga Bastos
• Associated scholarship(s): 24/04647-3 - Social inequalities in health in two cities of São Paulo State: measurement, monitoring and analysis, BP.TT; 23/07483-9 - Social inequalities in health in two cities of São Paulo State: measurement, monitoring and analysis, BP.TT; 23/06664-0 - Social inequalities in health in two cities of São Paulo State: measurement, monitoring and analysis, BP.TT; + associated scholarships 22/16527-7 - Social Inequalities in Health in two cities of São Paulo State: measurement, monitoring and analysis, BP.TT; 22/02515-7 - Social inequalities in health in two metropolis of São Paulo State: measurement, monitoring and analysis, BP.PD; 22/02340-2 - Social Inequalities in Health in two cities of São Paulo State: measurement, monitoring and analysis, BP.TT; 22/02376-7 - Social Inequalities in Health in two cities of São Paulo State: measurement, monitoring and analysis, BP.TT; 20/03013-0 - Social inequalities in health in two cities of São Paulo State: measurement, monitoring and analysis, BP.PD; 19/08722-1 - Social inequalities in health in two cities of São Paulo State: measurement, monitoring and analysis, BP.PD - associated scholarships

Abstract

Surveys conducted in countries of high socioeconomic level have registered that the magnitude of the social inequalities in health has remained stable or even has increased, depending on the health indicator analyzed. This is observed even in countries with public health care systems well structured. While a significant reduction of income concentration in the world had been observed between 1920 and 1970, a reversal of this trend began to show from 1980, so that in 2010 the degree of income concentration reached heights similar to 1910/20.Also, contribute to the current relevance of the theme of social inequalities in health the economic crisis that started in 2008 and has led several countries to a deep economic depression and to the adoption of policies of fiscal austerity. Studies on the impact of the crisis and the measures taken, detected the increase in the degree of social disparities in health in several health indicators analyzed. Brazil is recognized as one of the countries with the highest rates of income concentration, which, added to the economic crisis that the country is going through and the austerity policies that have been implemented, highlights the opportunity and relevance of research on health social inequalities to qualify the knowledge about the patterns and trends of social disparities in health, in two of the most important cities of São Paulo, which are the focus of this thematic project. Considering the existence of periodic population-based health surveys with wide thematic scope, developed in the cities of São Paulo and Campinas, originated from the multicenter Project ISA-SP (Process FAPESP no. 1998/14099-7) and the existence in these municipalities, since 1990, of programs developed to improve the quality of mortality information, the researchers of this thematic project aim, supported in special in those databases, to assess the magnitude of social disparities prevalent in multiple health dimensions and to monitor the changes of these inequalities over recent years. The objectives of this Thematic Project include: 1. Analysis of social disparities in health status, health behaviors, morbidities and use of health services based on the results of the surveys ISACapital 2015, ISACamp 2014/2015 and ISACamp 2020; 2. To monitor the differences of the social inequalities between successive surveys (2003, 2008, 2014/15 and 2020) using and comparing different techniques of analysis; 3. To develop the ISACamp 2020 to provide data for monitoring the health social inequalities; 4. Analysis of current social inequalities (2015/2016) and of trends over the past 20 to 30 years in mortality rates, comparing social strata defined by area of residence. 5. Analysis of social inequalities in life expectancy and of disability-free life expectancy. 6. Analysis of social inequalities in incidence and mortality from neoplasms based on Populacional based Registry of Cancer of Campinas. Different conceptions and theoretical alignments were historically used to support studies on social inequalities in health. The authors of this project consider that the conceptual framework adopted by the WHO Commission on Social Determinants in health comprises the different dimensions of the determinants of the health-disease process and is adequate to support the studies proposed in this thematic project. Different compositions of social strata will be used in the studies of this thematic project in order to take account the socio-economic inequalities, but also the ethnic and gender inequalities. The historical development of indicators and techniques to measure the magnitude of social inequalities also provides a list of options that will be explored in these studies in order to identify the measures and techniques most appropriate depending on the design of the study, the proposed hypotheses and the health indicator in focus. (AU)

Scientific publications

(5)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

SANTOS, EDIGE FELIPE DE SOUSA; LOUVISON, MARILIA CRISTINA PRADO; OLIVEIRA, ELAINE CRISTINA TORRES; MONTEIRO, CAMILA NASCIMENTO; BARROS, MARILISA BERTI DE AZEVEDO; GOLDBAUM, MOISES; CESAR, CHESTER LUIZ GALVAO. Analysis of education level in access and use of health care services, ISA-Capital, São Paulo, Brazil, 2003 and 2015. Cadernos de Saúde Pública, v. 39, n. 8, p. 12-pg., 2023-01-01. (20/03013-0, 17/23995-9)

MARIA DO CARMO FERREIRA; IVAN ARROYAVE; MARILISA BERTI DE AZEVEDO BARROS. Desigualdades sociais em câncer no sexo masculino em uma metrópole da região Sudeste do Brasil. Revista de Saúde Pública, v. 57, 2023-07-07. (17/23995-9)

KATIA CRISTINA BASSICHETTO; MARGARIDA MARIA DE AZEVEDO TENÓRIO LIRA; EDIGE FELIPE DE SOUSA SANTOS; IVAN ARROYAVE; SAMANTHA HASEGAWA FARIAS; MARILISA BERTI DE AZEVEDO BARROS. Mortalidade infantil no município de São Paulo: tendência e desigualdade social (2006–2019). Revista de Saúde Pública, v. 57, 2023-11-10. (20/03013-0, 17/23995-9)

MARGARIDA MARIA TENÓRIO DE AZEVEDO LIRA; KATIA CRISTINA BASSICHETTO; SAMANTHA HASEGAWA FARIAS; EDIGE FELIPE DE SOUSA SANTOS; MARILISA BERTI DE AZEVEDO BARROS. Desigualdades socioespaciais da mortalidade prematura por doenças crônicas não transmissíveis no município de São Paulo, Brasil, 2006-2019. Cad. saúde colet., v. 31, n. 3, 2023-11-13. (20/03013-0, 17/23995-9)

FERREIRA, M. C.; SARTI, F. M.; BARROS, M. B. A.. Social inequalities in the incidence, mortality, and survival of neoplasms in women from a municipality in Southeastern Brazil (vol 38, e00107521, 2022). Cadernos de Saúde Pública, v. 38, n. 3, p. 1-pg., 2022-01-01. (17/23995-9)