Associations between negative self-rated health and macro-structural, social and health vulnerability in elderly people: Fibra Study, Campinas, Brazil
DOI:
https://doi.org/10.15448/2357-9641.2014.2.21011Keywords:
Aging health, Self-rated health, Aged, socioeconomic factors, Health vulnerability, Living conditions.Abstract
Purpose: This study was aimed at investigating associations between negative self-rated health and macro-structural (access and use of medical, hospitalar and odontological services, as well as consumption of medicines), social (sex, age, schooling, individual income, living arrangements, expectancy of care, and social participation), and health indicators (chronic diseases, signals and symptoms, functional problems to feeding, cardiovascular risk, frailty, depressive symptoms, and cognitive status) in Brazilian elderly recruited in the community.
Methods: Participants were 2.597 seniors (65,7% women), aged 65 and above (M=72,4±5,6), without cognitive deficit suggestive of dementia. They integrated the probabilistic samples from 7 Brazilian cities selected by convenience. The variables were assessed by self-report, anthropometric and performance instruments and measures.
Results: Multivariate analyses of regression showed significant associations (p≤0,05) between self-rated health and having 3 or more signals and symptoms (OR=2,42), 3 or more functional problems to feeding (OR=2,30), individual income ≤ 3 MW (OR=2,17), no visits to the dentist in the last year (OR=2,09), consumption of 3 or more medicines (OR=2,02), 3 or more chronic illnesses (OR=2,00), illiteracy (OR=1,58), more than 4 nights of hospitalization (OR=1,17), and use of public health services (OR=1,06).
Conclusions: In multiple interaction, macro-structural, social and health indicators of vulnerability can generate a vicious cycle of deleterious influences over old people´s quality of life, which tend to reflect in negative self-rated health.
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Lima-Costa MF, Peixoto SV, Matos DL et al. Predictors of 10-year mortality in a population of community-dwelling Brazilian elderly: the Bambuí Cohort Study of Aging. Cad. Saúde Pública. 2011;27 Sup 3:S360-S369.
Ministério da Saúde. [Internet]. Secretaria de Vigilância em Saúde. Secretaria de Gestão Estratégica e Participativa. Vigitel Brasil 2009: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico. Brasília: 2010 [acesso 2012 jun 23]. Disponível em: http://portal.saude.gov.br/portal/arquivos/pdf/vigitel_2009_preliminar_web.pdf
Wagner DC, Short JL. Longitudinal predictors of self-rated health and mortality in older adults. Prev Chronic Dis. 2014; 5;11:E93.
Lima-Costa MF, Cesar CC, Chor D et al. Self-rated health compared with objectively measured health status as a tool for mortality risk screening in older adults: 10-year followup of the Bambuí Cohort Study of Aging. Am J Epidemiol. 2012;1;175(3):228-35.
Tinetti ME, McAvay G, Chang SS et al. Effect of chronic disease-related symptoms and impairments on universal health outcomes in older adults. J Am Geriatr Soc. 2011; 59(9):1618-27.
Borim FSA, Barros MBA, Neri AL. Autoavaliação da saúde em idosos: pesquisa debase populacional no Município de Campinas, São Paulo, Brasil. Cad. Saúde Pública. 2012; 28(4):769-80.
Feng X, Astell-Burt T. Neighborhood socioeconomic circumstances and the co-occurrence of unhealthy lifestyles: evidence from 206,457 Australians in the 45 and up study. PLoS One 2013;15;8(8):e72643.
Luz TCB, César CC, Lima-Costa MF et al. Satisfaction with the neighborhood environment and health in older elderly: cross-sectional evidence from the Bambuí Cohort Study of Aging. Cad. Saúde Pública. 2011;27 Sup 3:S390-8.
Bowling, A. Measuring health. A review of quality of life measurement scales. Berkshire, UK: Open University Press; 2005.
Maia FOM, Duarte YAO, Lebrão ML et al. Fatores de risco para mortalidade em idosos. Rev. Saúde Pública. 2006; 40(6):1049-56.
Hirve S. ‘In general, how do you feel today?’ self-rated health in the context of aging in India Global Health Action. 2014; 7:23421.
French DJ, Browning C, Kendig H et al. A simple measure with complex determinants: investigation of the correlates of self-rated health in older men and women from three continents. BMC Public Health. 2012;13;12:649.
Robert SA, Cherepanov D, Palta M et al. Socioeconomic status and age variations in health-related quality of life: Results from the National Health Measurement Study. J Gerontol B Psychol Sci Soc Sci. 2009;64B(3):378-89.
Crimmins EM, Kim JK, Solé-Auró A. Gender differences in health: results from SHARE, ELSA and HRS. Eur J Public Health. 2011;21(1):81-91.
Lima-Costa MF, de Oliveira C, Macinko J et al. Socioeconomic inequalities in health in older adults in Brazil and England. Am J Public Health. 2012;102(8): 1535-41.
Brenes-Camacho G. Favourable changes in economic wellbeing and self rated health among the elderly. Soc Sci Med. 2011;72(8):1228-35.
Louvison MCP, Lebrão ML, Duarte YAO et al. Desigualdades no uso e acesso aos serviços de saúde entre idosos do município de São Paulo. Rev Saúde Pública. 2008; 42(4):733-40.
Hernandes ESC, Lebrão ML, Duarte YAO et al. Idosos com e sem plano de saúde e características socioepidemiológicas associadas. Rev. Saúde Pública. 2012;46(6):1030-8.
Lima-Costa MF, Turci MA, Macinko J. Estratégia Saúde da Família em comparação a outras fontes de atenção: indicadores de uso e qualidade dos serviços de saúde em Belo Horizonte, Minas Gerais, Brasil. Cad. Saúde Pública. 2013;29(7):1370-80.
Torres JL, Dias RC, Ferreira F et al. Functional performance and social relations among the elderly in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil: a population-based epidemiological study. Cad. Saúde Pública. 2014;30(5):1018-28.
Caetano SC, Silva CM, Vettore MV. Gender differences in the association of perceived social support and social network with self-rated health status among older adults: a population-based study in Brazil. BMC Geriatr. 2013; 15;13:122.
Szanton CL, Seplaki RJ. Thorpe Jr RJ et al. Socioeconomic status is associated with frailty: the Women’s Health and Aging Studies. J Epidemiol Community Health. 2010; 64(1): 63-7.
Boehme S, Geiser C, Renneberg B. Functional and self-rated health mediate the association between physical indicators of diabetes and depressive symptoms. BMC Fam Pract. 2014; 20:15:157.
Kuh D, Ben-ShlomoY, Lynch J et al. Life course epidemiology. J Epidemiol Community Health. 2003;57(10):778.
Andrew AK, Keefe MK. Social vulnerability from a social ecology perspective: a cohort study of older adults from the National Population Health Survey of Canada. BMC Geriatrics. 2014;14:90.
Rodrigues NO, Neri AL.Vulnerabilidade social, individual e programática em idosos da comunidade: dados do estudo FIBRA, Campinas, SP, Brasil. Cien Saude Colet. 2012;17(8):2129-39.
Ayres J, Calazans GJ, Saletti Filho HC et al. Risco, vulnerabilidade e práticas de prevenção epromoção da saúde. In: Campos G, Minayo MCS,Akerman M, Drumond Jr M, Carvalho YM, orga-nizadores. Tratado de Saúde Coletiva. São Paulo: Editora Fiocruz; 2006. p. 375-41.
Maia FOM, Duarte YAO, Secoli SR et al. Adaptação transcultural do Vulnerable Elders Survey-13 (VES-13): contribuindo para a identificação de idosos vulneráveis. Rev Esc Enferm USP. 2012;46(Esp):116-2.
Neri AL, Yassuda MS, Araújo LFA et al. Metodologia e perfil sociodemográfico, cognitivo e de fragilidade de idosos comunitários de sete cidades brasileiras: Estudo FIBRA. Cad. Saúde Pública. 2013;29(4):778-92.
Fried LP, Tangen CM, Walston J et al. Frailty in older adults:evidence for a phenotype. J Gerontol A BiolSciMedSci. 2001;56:M146-56.
Brucki SMD, Nitrini R, Caramelli P et al. Sugestões para o uso do Mini Exame do Estado Mental no Brasil. ArqNeuropsiquiatr. 2003;61:777-81.
Reuben DB, Laliberte L, Hiris J et al. A hierarchical exercise scale to measure function at the Advanced Activities of Daily Living (AADL) level. J Am Geriatr Soc. 1990;38: 855-61.
LohmanTG, Roche AF, Martorell R. Anthropometric standardization reference manual. Illinois: Human Kinetics Books 1988.
Almeida OP, Almeida SA. Short versions of the Geriatric Depression Scale: A study of their validity for the diagnosis of major depressive episode according to ICD-10 and DSM-IV. Int J Geriatr Psychiatry. 1999;14(10):858-65.
Andrade FB, Lebrão ML, Santos JLF et al. Factors related to poor self perceived oral health among community-dwelling elderly individuals in São Paull, Brazil 2012. Cad Saúde Pública. 2012;28(10):1965-75.
Luz TCB, LoyolaFilho AI, Lima-Costa MF. Social capital and under utilization of medication for financial reasons among elderly women: evidence from two Brazilian health surveys. Ciênc. Saúde Coletiva. 2013;18(12):3721-30.
Steptoe A, Feldman PJ, Kunz S et al. Stress responsivity and socioeconomic status: A mechanism for increased cardiovascular disease risk? Eur Heart J. 2002;23: 1757-63.
Carvalho MFC, Romano-Lieber NS, Bergsten-Mendes G et al. Polifarmácia entre idosos do Município de São Paulo – Estudo SABE. Rev bras epidemiol. 2012;15(4): 817-27.
Cassoni TCJ, Corona LP, Romano-Lieber NS et al. Uso de medicamentos potencialmente inapropriados por idosos do Município de São Paulo, Brasil: Estudo SABE. Cad. Saúde Pública. 2014;30(8):1708-20.
Santos TRA, Lima DM, Nakatani AYK et al. Consumo de medicamentos por idosos, Goiânia, Brasil. Rev. Saúde Pública. 2013;47(1):94-103.
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