☆ 4.4 Article

Trends in hospitalizations for primary care sensitive conditions following the implementation of Family Health Teams in Belo Horizonte, Brazil

HEALTH POLICY AND PLANNING (2012)

Journal

HEALTH POLICY AND PLANNING

Volume 27, Issue 4, Pages 348-355

Publisher

OXFORD UNIV PRESS

DOI: 10.1093/heapol/czr043

Keywords

Primary health care; primary care sensitive conditions; hospitalization; equity; Brazil

Categories

Health Care Sciences & Services Health Policy & Services

Funding

Brazilian Ministry of Health
National Institute of Science and Technology for Health Technology Assessment (IATS) - CNPq/Brazil [573826/2008-0]

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Abstract

Methods We conducted an ecological study covering 2003 to 2006, using mixed models to investigate time trends in public system hospitalizations as well as their association with social vulnerability and primary care team characteristics. Results Sensitive conditions accounted for 115 340 (26.4%) hospitalizations. Over the 4-year period, hospitalizations for sensitive conditions declined by 17.9%, vs only 8.3% for non-sensitive ones (P < 0.001). Hospitalization for sensitive conditions declined 22% for women in areas of high social vulnerability vs 9% for women in areas of low vulnerability (P < 0.001); for men, 17% vs 10% (P = 0.11). Conclusions Though the ecologic nature of our study limits the confidence with which conclusions can be affirmed, the Family Health Strategy appears to have contributed to a major reduction in hospitalizations due to primary care sensitive conditions in this large Brazilian metropolis, while at the same time promoting greater health equity.

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Spatial clusters of diabetes: individual and neighborhood characteristics in the ELSA-Brasil cohort study

Fernando Luiz Pereira de Oliveira, Adriano Marcal Pimenta, Bruce Bartholow Duncan, Rosane Harter Griep, Gustavo de Souza, Sandhi Maria Barreto, Luana Giatti

Summary: This study identified spatial clusters of type 2 diabetes mellitus among participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) residing in two cities and verified individual and neighborhood socio-economic environmental characteristics associated with the spatial clusters. Logistic regression models were fitted to estimate the magnitude of associations. In both cities, participants living in the high type 2 diabetes mellitus cluster area were more likely to be mixed-race or black and have a low schooling level and manual work; these were also considered low-income areas. On the other hand, participants in the low type 2 diabetes mellitus cluster area of Salvador were less likely to be black and have low schooling level (university degree) and live in a low-income area. More vulnerable individual and neighborhood socioeconomic characteristics were associated with living in clusters of higher type 2 diabetes mellitus occurrence, whereas better contextual profiles were associated with clusters of lower prevalence.

CADERNOS DE SAUDE PUBLICA (2023)

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Article Public, Environmental & Occupational Health

Liver steatosis as a predictor of incident diabetes in adults: a prospective evaluation in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Luciana Costa Faria, Maria de Fatima Haueisen Sander Diniz, Luana Giatti, Maria Ines Schmidt, Alessandra Carvalho Goulart, Bruce Bartholow Duncan, Sandhi Maria Barreto

Summary: There is a bidirectional relationship between non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes, with NAFLD possibly preceding and/or promoting the development of diabetes. This study investigates the association between liver steatosis and the incidence of diabetes using data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The results show that hepatic steatosis is an independent predictor of incident diabetes in the ELSA-Brasil cohort study.

CADERNOS DE SAUDE PUBLICA (2023)

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Article Clinical Neurology

Optimal cardiovascular health is associated with slower cognitive decline

Naomi Vidal Ferreira, Natalia Gomes Goncalves, Claudia Szlejf, Alessandra C. Goulart, Itamar de Souza Santos, Bruce B. Duncan, Maria Ines Schmidt, Sandhi Maria Barreto, Paulo Caramelli, Natan Feter, Raphael Machado Castilhos, Luciano F. Drager, Paulo Lotufo, Isabela Bensenor, Claudia Kimie Suemoto

Summary: This study found that higher baseline scores on Life's Essential 8 (LE8), which includes sleep and other health factors, were associated with slower cognitive decline over an 8-year follow-up period. The association was mainly driven by health factors such as blood glucose and blood pressure. Age, sex, and race were also modifiers of this association.

EUROPEAN JOURNAL OF NEUROLOGY (2023)

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Article Endocrinology & Metabolism

Association between ultra-processed food consumption and the incidence of type 2 diabetes: the ELSA-Brasil cohort

Scheine L. Canhada, Alvaro Vigo, Renata Levy, Vivian C. Luft, Maria de Jesus M. da Fonseca, Luana Giatti, Maria del Carmen B. Molina, Bruce B. Duncan, Maria Ines Schmidt

Summary: Consumption of ultra-processed food is associated with an increased risk of type 2 diabetes in Brazilian adults, with varying risks for specific food items. These findings support recommendations to avoid the intake of ultra-processed food for diabetes prevention and management.

DIABETOLOGY & METABOLIC SYNDROME (2023)

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Article Public, Environmental & Occupational Health

Self-reported diabetes and factors associated with it in the Brazilian adult population: National Health Survey, 2019

Deborah Carvalho Malta, Regina Tomie Ivata Bernal, Ana Carolina Micheletti Gomide Nogueira de Sa, Tercia Moreira Ribeiro da Silva, Betine Pinto Moehlecke Iser, Bruce Bartholow Duncan, Maria Ines Schimdt

Summary: This study aims to analyze the prevalence of self-reported diabetes and its associated factors in the Brazilian adult population. The study found that factors associated with diabetes in Brazilian adults include age, region of residence, smoking history, self-assessment of health, heart disease, hypertension, high cholesterol, overweight, and obesity. These results can guide public policies for the prevention and control of disease in Brazil.

CIENCIA & SAUDE COLETIVA (2022)

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