Hospital admissions due to respiratory diseases in children in the municipality of São Paulo and their relationship with climatic conditions and the socioeconomic context

Author(s)

Sara Lopes de Moraes

• Document type: Master's Dissertation
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Filosofia, Letras e Ciências Humanas (FFLCH/SBD)
• Defense date: 2018-07-05

Examining board members

Emerson Galvani; Tarik Rezende de Azevedo; Francisco Chiaravalloti Neto; Marina Jorge de Miranda

• Advisor: Emerson Galvani; Ligia Vizeu Barrozo

Abstract

The urban climate change, the excessive air pollution, the large social inequalities and segregation in the cities have become a determinant factors of high morbidity and mortality rates due to respiratory diseases. Therefore, the aims of this research was to understand how the climatic attributes, air pollution and socioeconomic conditions are related with hospital admissions for respiratory diseases in children up to 9 years of age in 14 districts of São Paulo. This research were divided into two working steps; the first step was the relationship between the meteorological variables, thermal comfort indexes and air pollution (PM10) with hospital admissions during 2003 to 2013, based on the statistical models of binomial distribution and Distributed Lag Model Non-linear Model. The second step was to analyze the spatial pattern between the Smoothed Standardized Admissions Ratio - RPIS and the deprivation index of the population in the study area over the period 2006-2013, considering the spatial autocorrelation and the spatial models, Ordinary Least Squares and Geographically Weighted Regression. The results showed significant relationship between the high relative risk with the mean air temperature (17.5ºC at 21°C, for the total), relative humidity (84% to 98% for females), rainfall (0 mm to 2.3mm for the total and both sexes and > 120 mm for the females) and PM10 (> 35g/m³ for the total and for the females). It was possible to identify the highest and lowest social deprivation material spatial pattern in the study area, and it was possible to identify the spatial pattern of the RPIS. The spatial dependence results showed a significant relationship between the deprivation index and RPIS. Therefore, these results allowed us to identify the most and least vulnerable census tracts related to respiratory diseases. In addition, we found that female children presented high risk (RR = 2.30) when they were related to greater deprivation. This research, therefore, allowed us to conclude that certain intervals (specific values) of climatic attributes and the deprivation index may contribute to increase the hospital admissions of respiratory diseases in children from 0 to 9 years of age in the study area. (AU)

• FAPESP's process: 16/06963-3 - The climatic influence and correlations in respiratory morbidity among children in the City of São Paulo
• Grantee: Sara Lopes de Moraes
• Support Opportunities: Scholarships in Brazil - Master