Ferreira Fabiane Ribeiro, César Cibele Comini, Andrade Fabíola Bof de, Souza Junior Paulo Roberto Borges de, Lima-Costa Maria Fernanda, Proietti Fernando Augusto
Universidade Federal de Minas Gerais. Escola de Educação Física, Fisioterapia e Terapia Ocupacional. Departamento de Fisioterapia. Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais. Faculdade de Ciências Econômicas. Centro de Desenvolvimento e Planejamento Regional. Belo Horizonte, MG, Brasil.
Rev Saude Publica. 2018 Oct 25;52Suppl 2(Suppl 2):18s. doi: 10.11606/S1518-8787.2018052000647.
To determine the impact of the physical and social surroundings of the neighborhood, which are presented as facilitators or barriers for the social participation of Brazilian older adults.
The study was conducted in a probabilistic representative sample of the Brazilian population aged 50 years and older and who lived in urban areas (n = 7,935). The response variable was social participation, which was defined from two questions about activities performed with other persons: visited friends or relatives in their homes in the last 12 months (yes, no); went out with other persons to public places, such as restaurant, movies, club, park, in the last 12 months (yes, no). The explanatory variables included fear of falling because of defects in sidewalks, concern about the difficulty to get on a bus, subway, or train, difficulty to cross streets, and perception of violence in the neighborhood. Potential confounding variables included age, marital status, education level, self-rated health, living in an asphalted or paved street, time living in the municipality, and socioeconomic position score. Prevalence ratios and respective confidence intervals were estimated using Poisson regression.
Difficulty to cross streets presented an independent association with restricted social participation (PR = 0.95; 95%CI 0.93-0.98) among both women (PR = 0.96; 95%CI 0.92-0.99) and men (PR = 0.94; 95%CI 0.90-0.99). Concern about the difficulty to get on a bus, subway, or train was associated with the outcome only among men (PR = 0.95; 95%CI 0.91-0.99). The fear of falling because of defects in sidewalks and the perception of violence in the neighborhood were not associated with social participation.
Urban characteristics that hinder the crossing of streets and accessibility to public transport can be inferred as important barriers for the social participation of Brazilian older adults.
确定社区的物理和社会环境对巴西老年人社会参与的促进或阻碍作用。
该研究采用概率抽样法,选取了年龄在50岁及以上、居住在城市地区的巴西人群作为代表性样本(n = 7935)。反应变量为社会参与,通过两个关于与他人一起进行活动的问题来定义:在过去12个月内是否去朋友或亲戚家拜访过(是,否);在过去12个月内是否与他人一起去过公共场所,如餐馆、电影院、俱乐部、公园等(是,否)。解释变量包括因人行道缺陷而害怕摔倒、担心乘坐公交车、地铁或火车困难、过马路困难以及对社区暴力的感知。潜在混杂变量包括年龄、婚姻状况、教育水平、自评健康状况、居住在柏油或铺砌街道、在该市居住时间以及社会经济地位得分。使用泊松回归估计患病率比及其相应的置信区间。
过马路困难与社会参与受限存在独立关联(患病率比=0.95;95%置信区间0.93 - 0.98),在女性(患病率比=0.96;95%置信区间0.92 - 0.99)和男性中均如此(患病率比=0.94;95%置信区间0.90 - 0.99)。仅在男性中,担心乘坐公交车、地铁或火车困难与结果相关(患病率比=0.95;95%置信区间0.91 - 0.99)。因人行道缺陷而害怕摔倒以及对社区暴力的感知与社会参与无关。
阻碍过马路和公共交通可达性的城市特征可被推断为巴西老年人社会参与的重要障碍。