Duque Andrezza Marques, Peixoto Marcus Valerius, Lima Shirley V M A, Goes Marco Aurélio O, Santos Allan D, Araújo Karina Conceição Gomes Machado, Nunes Marco Antonio P
Department of Occupational Therapy; Post-Graduate Program in Health Sciences, Federal University of Sergipe, Sergipe.
Geospat Health. 2018 Nov 12;13(2). doi: 10.4081/gh.2018.702.
The process of population aging is a worldwide reality becoming a global public health challenge. Although population aging is especially noticeable in more developed regions, there has also been a significant advance in the quantity of elderly people in areas with unfavourable socioeconomic indicators, and a rapid growth in countries with a low level of economic development. This article presents an analysis based on spatial autocorrelation of the relationship between life expectancy and social determinants in a north-eastern region of Brazil. An ecological study was conducted using the secondary data of social, demographic, and health indicators of elderly people collected in the Brazilian Demographic Census of the 75 municipalities of the state of Sergipe. Spatial autocorrelation was evaluated using the Moran global index and the local indicators of space association. Multiple linear regression models were used to identify the relationship between life expectancy and social determinants. The South-eastern region of the state presented clusters with all indicators pointing to acceptable lifestyles, whereas the municipalities of the north-western and far-eastern regions were characterized by values demonstrating precarious living conditions. The high dependency ratio, illiteracy rate, and unemployment rate among elderly people had a negative impact on life expectancy. The evidence confirms that there is an autocorrelation between social determinants and life expectancy, indicating that the worse the social, economic, and health indicators are, the lower the life expectancy. This finding indicates the need to redirect public policies and formulate strategies aimed at reducing social and health inequalities.
人口老龄化进程是一个全球性现实，正成为一项全球公共卫生挑战。尽管人口老龄化在较发达地区尤为明显，但在社会经济指标不利地区的老年人口数量也有显著增长，且在经济发展水平较低的国家增长迅速。本文基于空间自相关分析了巴西东北部一个地区预期寿命与社会决定因素之间的关系。利用在塞尔希培州75个市的巴西人口普查中收集的老年人社会、人口和健康指标的二手数据进行了一项生态研究。使用莫兰全局指数和局部空间关联指标评估空间自相关。采用多元线性回归模型确定预期寿命与社会决定因素之间的关系。该州东南部地区呈现出各类指标均指向可接受生活方式的聚类，而西北部和最东部地区的市则以表明生活条件不稳定的数值为特征。老年人中的高抚养比、文盲率和失业率对预期寿命有负面影响。证据证实社会决定因素与预期寿命之间存在自相关，表明社会、经济和健康指标越差，预期寿命越低。这一发现表明需要重新调整公共政策并制定旨在减少社会和健康不平等的战略。
