ANÁLISE DA SUFICIÊNCIA DA ATIVIDADE FÍSICA ASSOCIADO AO ÍNDICE DE DESENVOLVIMENTO HUMANO MUNICIPAL NAS CAPITAIS BRASILEIRAS

The Municipal Human Development Index (MHDI) is proposed to measure the development stage of a population in a certain space and time. Determinants whit income, education and health compose the facets used in the calculation of this index. The practice of physical activity (PA) in everyday life presents itself as an important indicator of health. This article is concerned with knowing the correlation between the prevalence of PA enough with their respective domicile’s MHDI. The correlated data were collected through the report of the Surveillance System of Risk Factors for Chronic Diseases Protection Telephone Survey (VIGITEL/2010) and the Firjan Municipal Development Index (MHDI)/2009. All capitals of the Federation showed a FMDI moderate to high, with a higher value for the city of Curitiba (0.87) and lower for the city of Rio Branco (0.69). The two more prevalence of individuals sufficiently active (22.4% and 20%) were found in Brasilia and Palmas, occupying the 8th and 17th position in the ranking of MHDI, respectively. The capitals of the northern region of the country had lower MHDI and accumulated the highest prevalence of PA enough. This study did not find statistically significant correlation between individuals considered sufficiently active and MHDI in the capitals of the Federation (r = 0.14)

Fatores de estilo de vida, gastos diretos e indiretos por companhia aérea brasileira

OBJECTIVE To analyze lifestyle risk factors related to direct healthcare costs and the indirect costs due to sick leave among workers of an airline company in Brazil. METHODS In this longitudinal 12-month study of 2,201 employees of a Brazilian airline company, the costs of sick leave and healthcare were the primary outcomes of interest. Information on the independent variables, such as gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity, and smoking), was collected using a questionnaire on enrolment in the study. Data on sick leave days were available from the company register, and data on healthcare costs were obtained from insurance records. Multivariate linear regression analysis was used to investigate the association between direct and indirect healthcare costs with sociodemographic, work, and lifestyle-related factors. RESULTS Over the 12-month study period, the average direct healthcare expenditure per worker was US$505.00 and the average indirect cost because of sick leave was US$249.00 per worker. Direct costs were more than twice the indirect costs and both were higher in women. Body mass index was a determinant of direct costs and smoking was a determinant of indirect costs. CONCLUSIONS Obesity and smoking among workers in a Brazilian airline company were associated with increased health costs. Therefore, promoting a healthy diet, physical activity, and anti-tobacco campaigns are important targets for health promotion in this study population.OBJETIVO Analisar fatores de estilo de vida relacionados aos gastos diretos com saúde e indiretos com absenteísmo de trabalhadores de companhia aérea brasileira. MÉTODOS Coorte retrospectiva com 2.201 trabalhadores de uma companhia área de São Paulo, SP, em 2010. Os desfechos de interesse foram: gastos com serviços de saúde e com ausência no trabalho. As variáveis independentes sexo, idade, nível educacional, tipo de trabalho, estresse e fatores relacionados ao estilo de vida (índice de massa corporal, atividade física e tabagismo) foram obtidas por entrevista. Informações sobre absenteísmo foram obtidas dos registros da companhia aérea e dados sobre serviços de saúde foram informados pela operadora de saúde responsável pelo plano de saúde dos funcionários da empresa. Foi realizada regressão linear múltipla para analisar a associação entre as variáveis. RESULTADOS A média de gastos por trabalhador foi de US$505,00 com serviços de saúde e US$249,00 devido ao absenteísmo nos 12 meses de seguimento. Gastos diretos foram superiores aos gastos indiretos e ambos foram maiores em mulheres. Índice de massa corporal e tabagismo associaram-se a gastos diretos e indiretos, respectivamente. CONCLUSÕES Excesso de peso e tabagismo significaram maiores gastos dentro de um ano, o que sugere que dieta saudável, atividade física e controle do tabagismo são importantes alvos em programas de promoção da saúde para a população estudada

La perspectiva feminista de la interseccionalidad en el campo de la salud pública: revisión narrativa de las producciones teórico-metodológicas

El abordaje de la interseccionalidad emergió a fines de la década de 1980, en el campo del activismo feminista negro en EEUU, como crítica a los análisis unidimensionales de las desigualdades sociales. Esta revisión narrativa descriptivo-analítica presenta el estado actual de la inclusión teórico-metodológica de la interseccionalidad en la salud pública. Se consultaron siete bases de bibliografía científica: Web of Science, Embase, Cinahl, Scopus, Sociological Abstracts, Lilacs y Medline, y se obtuvieron 1.763 artículos. Eliminados los duplicados y leídos los títulos y resúmenes, se seleccionaron 30 artículos producidos en cinco países entre 2006 y 2017. El análisis, estructurado en tres temas (debates teórico-metodológicos; marcadores sociales –género, raza, etnicidad, orientación sexual–; y políticas y prácticas de salud), muestra que la interseccionalidad es un recurso analítico prometedor para la comprensión y el enfrentamiento del desafío global de las desigualdades en salud

La perspectiva feminista de la interseccionalidad en el campo de la salud pública: revisión narrativa de las producciones teórico-metodológicas

The intersectionality approach emerged in the late 1990s in the field of black feminist activism in the USA, as a critique of one-dimensional analyses of social inequalities. This descriptive-analytical narrative review presents the current state of theoretical-methodological inclusion of intersectionality in public health. Seven scientific literature databases were consulted: Web of Science, Embase, Cinahl, Scopus, Sociological Abstracts, Lilacs, and Medline, resulting in 1763 papers. After duplicates were eliminated and the titles and abstracts screened, 30 papers produced in five countries between 2006 and 2017 were selected. The analysis, structured into three central themes (theoretical-methodological debates, social markers – gender, race, ethnicity and sexual orientation – and health policies and practices), shows intersectionality to be a promising analytical resource for understanding and facing the global challenge of inequalities in health.El abordaje de la interseccionalidad emergió a fines de la década de 1980, en el campo del activismo feminista negro en EEUU, como crítica a los análisis unidimensionales de las desigualdades sociales. Esta revisión narrativa descriptivo-analítica presenta el estado actual de la inclusión teórico-metodológica de la interseccionalidad en la salud pública. Se consultaron siete bases de bibliografía científica: Web of Science, Embase, Cinahl, Scopus, Sociological Abstracts, Lilacs y Medline, y se obtuvieron 1.763 artículos. Eliminados los duplicados y leídos los títulos y resúmenes, se seleccionaron 30 artículos producidos en cinco países entre 2006 y 2017. El análisis, estructurado en tres temas (debates teórico-metodológicos; marcadores sociales –género, raza, etnicidad, orientación sexual–; y políticas y prácticas de salud), muestra que la interseccionalidad es un recurso analítico prometedor para la comprensión y el enfrentamiento del desafío global de las desigualdades en salud

Efeitos da poluição do ar nas doenças cardiovasculares: estruturas de defasagem

OBJETIVO: Investigar a estrutura de defasagem entre exposição à poluição do ar e internações hospitalares por doenças cardiovasculares em idosos, separada por gênero. MÉTODOS: Os dados de saúde de pessoas com mais de 64 anos de idade foram estratificados por gênero, na cidade de São Paulo, entre 1996 e 2001. Os níveis diários de poluentes do ar (CO, PM10, O3, NO2, SO2) e os dados de temperatura mínima e umidade relativa do ar foram também foram analisados. Foram utilizados modelos restritos de distribuição polinomial em modelos aditivos generalizados de regressão de Poisson para estimar os efeitos dos poluentes no dia da exposição e até 20 dias após, controlando-se para sazonalidades de longa e curta durações, feriados e fatores meteorológicos. RESULTADOS: Variações interquartis de PM10 (26,21 mig/m³) e SO2 (10,73 mig/m³) foram associados com aumentos de 3,17% (IC 95%: 2,09-4,25) nas admissões por insuficiência cardíaca congestiva e de 0,89% (IC 95%: 0,18-1,61) para admissões por todas as doenças cardiovasculares no dia da exposição, respectivamente. Os efeitos foram predominantemente agudos e maiores para o gênero feminino. Além disso, foi observado efeito colheita. CONCLUSÕES: Os achados mostraram que as doenças cardiovasculares em São Paulo são fortemente afetadas pela poluição do ar.OBJECTIVE: To assess the lag structure between air pollution exposure and elderly cardiovascular diseases hospital admissions, by gender. METHODS: Health data of people aged 64 years or older was stratified by gender in São Paulo city, Southeastern Brazil, from 1996 to 2001. Daily levels of air pollutants (CO, PM10, O3, NO2, and SO2) , minimum temperature, and relative humidity were also analyzed. It were fitted generalized additive Poisson regressions and used constrained distributed lag models adjusted for long time trend, weekdays, weather and holidays to assess the lagged effects of air pollutants on hospital admissions up to 20 days after exposure. RESULTS: Interquartile range increases in PM10 (26.21 mug/m³) and SO2 (10.73 mug/m³) were associated with 3.17% (95% CI: 2.09-4.25) increase in congestive heart failure and 0.89% (95% CI: 0.18-1.61) increase in total cardiovascular diseases at lag 0, respectively. Effects were higher among female group for most of the analyzed outcomes. Effects of air pollutants for different outcomes and gender groups were predominately acute and some "harvesting" were found. CONLUSIONS: The results show that cardiovascular diseases in São Paulo are strongly affected by air pollution

The influence of lifestyle and gender on sickness absence in Brazilian workers

Background\ud Despite an increasing body of knowledge concerning gender and lifestyle factors as determinants of sickness absence in well-developed countries, the relationship between these variables has not been elucidated in emerging economic power countries, where the burden of non-communicable diseases is particularly high. This study aimed to analyze the relationships among lifestyle-related factors and sick leave and to examine whether gender differences in sickness absence can be explained by differences in socio-demographic, work and lifestyle-related factors among Brazilian workers.\ud \ud \ud Methods\ud In this longitudinal study with a one year follow-up among 2.150 employees of a Brazilian airline company, sick leave was the primary outcome of interest. Independent variables collected by interview at enrolment in the study were gender, age, educational level, type of work, stress, and lifestyle-related factors (body mass index, physical activity and smoking). In addition, the risk for coronary heart disease was determined based on measurement of blood pressure, total cholesterol and glucose levels. The total number of days on sick leave during 12 months follow-up was available from the company register. Logistic regression analysis was used to determine the influence of socio-demographic, type of work and lifestyle-related factors on sick leave.\ud \ud \ud Results\ud Younger employees, those with lower educational level, those who worked as air crew members and those with higher levels of stress were more likely to have sick leave. Body mass index and level of physical activity were not associated with sick leave. After adjustment by socio-demographic variables, increased odds for 10 or more days of sick leave were found in smokers (OR = 1.51, CI = 1.05-2.17), and ex-smokers (OR = 1.45, CI = 1.01-2.10). Women were more likely to have 10 or more days of sick leave. Gender differences were reduced mainly when adjusted for type of work (15%) and educational level (7%).\ud \ud \ud Conclusions\ud The higher occurrence of sick leave among women than among men was partly explained by type of work and educational level. Our results suggest that type of work, a stressful life, and smoking are important targets for health promotion in this study population.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – CAPE

O padrão da atividade física de brasileiros diabéticos

The objective of this study was to describe the profile of physical activity (PA) of Brazilian adults with diabetes mellitus (DM), living in large urban centers in Brazil, in addition to verifying whether the practice aligns the physical activity guidelines recommended for diabetics by the Ministry of Health (MOH) Brazilian. Cross-sectional data were obtained from the Risk and Protective Factors Surveillance System for Chronic Diseases Transmissible not 2016, where about 54,000 adults aged 18 or more in all Brazilian capitals are surveyed annually by telephone survey. Participants were asked about the practice of some physical exercise or sport in the last 3 months on the weekly frequency and duration of practice and carried diabetes; if so, an automatic filter was used in the data sheet to identify them. Descriptive analysis was performed and the statistical significance assessed using the chi-square test (χ2) Pearson. In 2016, about 7.9% of the population declared diabetic with higher prevalence among older and less educated women. Walking, water aerobics and general fitness were preferred PA modes. More than half of diabetics (55%) were inactive and only 15% met the MS PA recommendations. The majority (90%) practiced for 30 minutes or more per day. Most diabetic patients (87%) with weekly AF 1 to 2 times did not reach the target. Health services should make explicit the need for PA regularity for diabetics, which the benefits are widely recognized.O objetivo do estudo visou conhecer a organização da prática de atividade física (AF) de brasileiros adultos portadores de diabetes mellitus, residentes nas 27 capitais brasileiras e verificou se a AF estava de acordo com as diretrizes de AF recomendadas para diabéticos pelo Ministério da Saúde brasileiro. Os dados transversais foram obtidos do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas não Transmissíveis de 2016, onde cerca de 54.000 adultos com 18 anos ou mais de idade em todas as capitais brasileiras foram entrevistados por inquérito telefônico. Os participantes informaram sobre a participação de AF recreativa executado nos três meses anteriores à entrevista, sobre a frequência semanal e a duração das atividades. Também informaram serem ou não diabéticos. Foi realizada análise descritiva e o significado estatístico avaliado por meio do teste do qui-quadrado (χ2) de Pearson. No ano de 2016, aproximadamente 7,9% da população se declarou diabética. Houve maior prevalência entre as mulheres de maior idade e de menor escolaridade. A caminhada, a hidroginástica e a ginástica geral foram as principais modalidades de AF referidas pelos diabéticos. Mais da metade deles (55%) estavam inativos e 15% alcançavam às recomendações de AF do MS. A maioria (90%) praticava AF por 30 minutos ou mais por dia, sendo que 87% dos ativos com frequência semanal de 1 a 2 vezes não alcançaram a meta recomendada pelo MS. A regularidade da AF para os diabéticos não está alinhada às recomendações do Ministério da Saúde brasileiro