Social inequalities in health of the elderly in the Campinas Metropolitan Region

Author(s)

Viviane Lazari Simomura

• Document type: Master's Dissertation
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Instituto de Filosofia e Ciências Humanas
• Defense date: 2013-03-22

Examining board members

Tirza Aidar; Maria Rita Donalisio Cordeiro; Jose Marcos Pinto da Cunha

• Advisor: Tirza Aidar

Abstract

The recognition and analysis of the inequalities in health are important to understand the complex health, disease, care and death process for the qualification of the information in health and, consequently, the support of public policies and sanitary interventions in the search for equity. Although many studies are dedicated to the understanding of how the social inequalities affect the health and mortality conditions of the population, in Brazilian literature studies designed specifically for old population are still scarce. This paper seeks to contribute for the subject, evaluating differentials in the epidemiological levels and patterns of the adult and elder population's mortality in the context of the Campinas Metropolitan Region (CMR): of high economic development and a wide delivery of health services - of low, medium and high complexity, on the one hand, but of high social inequalities on the other. Three main questions guided the research: (1) Do the differentials in favor of the lower death rate of population groups that live in better conditions, already broadly identified in the maternal child and juvenile health literature continue in the adult and older ages? (2) If the answer is yes, are these differentials independent from death causes? (3) Is there evidence of survival effect reflected on the reduction of the differentials in older ages? For this reason, estimates of mortality rates of the population 45 years or more, by gender, age groups and the main death causes in the CMR, in 2003 and 2004 were analyzed. The data analyzed are from the death register system, georeferenced according to the address, considering four differentiated areas according to social vulnerability. The results indicate that, for the population of 45 to 59 and 60 to 69 years, the noblest consolidated areas of the CMR present mortality rates always much lower than the others, regardless of gender and, with very rare exceptions, from the large and main groups of analyzed causes. Confidence intervals calculated for ratio among the rates show that the differentials is statistically significant, and that these differentials are reduced, in the more advanced ages (from 70 to 79 and 80 years or more), indicating the existence of survival bias (AU)

• FAPESP's process: 10/14740-8 - Social inequalities in health and adult population of elderly in metropolitan region of Campinas
• Grantee: Viviane Lazari Simomura
• Support type: Scholarships in Brazil - Master