Health vulnerability in the context of environmental changes: the case of waterborne diseases in Caraguatatuba, North Coast - SP

Author(s)

Gabriela Farias Asmus

• Document type: Doctoral Thesis
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Instituto de Filosofia e Ciências Humanas
• Defense date: 2014-10-21

Examining board members

Sônia Regina da Cal Seixas; Francisco de Assis Mendonça; João Luiz de Moraes Hoefel; Roberto Luiz do Carmo; Jurandir Zullo Junior

• Advisor: Sônia Regina da Cal Seixas; Simone Aparecida Vieira

Abstract

In the late modern society, we face the consequences of deep social and environmental changes that are self-presented from the second half of the 21st century: accelerated urbanization, pollution and natural resources degradation, biodiversity depletion, and global warming. Simultaneously, strong social inequities characterize this environment, where segments of the population are excluded from goods and services essential for human health and wellbeing, among many others. Temperature rising and changes in rainfall patterns predicted for the next decades are among the most discussed environmental changes nowadays. They represent the new risks and uncertainties for the future of health questions already present in society, especially those associated with waterborne diseases. The present study identified the vulnerabilities on health associated with environmental changes at the Northern coast of São Paulo State, using waterborne diseases as object of analysis ¿ especially acute diarrhea ¿ and the Caraguatatuba municipality as a study site. Environmental sanitation, climatic rhythm and cultural aspects were the main analytic categories used to explain the observed patterns of acute diarrhea in Caraguatatuba, which currently shows morbidity rates 40% higher than those observed 10 years ago. Children are proportionally more affected, but it stands out the fact that 46% of the annual morbidity falls to the adult population. It¿s observed that diarrhoea records are superior at the 8 first weeks of the year. Temperature and rainfall explain the diarrhea incidence in almost all ages analyzed. Spatial distribution from the cases recorded between 2005 and 2010 demonstrated that its incidence is not correlated to the places without access to safe water, not even to the places with the highest rates of people deprived of sewage and garbage collection. Moreover, diarrhoea was not related to the potential flooding areas at the municipality. This evidences that the local which houses the contamination is not associated to the address of the patient. The main contamination sources were food and water consumed outside their houses, where they cannot attest hygiene and treatment. At the same time, it was evidenced a cultural behavior associated with "veraneio". Population common sense tells that diarrhoea is not considered a "problem", but a momentary state of discomfort inside normality. It was concluded that within the context of environmental changes, a potential increase in temperature and rainfall are considered important elements for the health vulnerability of the Caraguatatuba inhabitants. Other important elements are associated with cultural particularities of a touristic and coastal city that possesses a differentiated feeding behavior during summer season (AU)

• FAPESP's process: 10/09558-6 - Climate variability and diarrheal diseases: patterns, vulnerability and trends in Caraguatatuba county - SP
• Grantee: Gabriela Farias Asmus
• Support Opportunities: Scholarships in Brazil - Doctorate