Sousa Jailson Lopes de, Alencar Gizelton Pereira, Antunes José Leopoldo Ferreira, Silva Zilda Pereira da
Instituto Brasileiro de Geografia e Estatística, São Paulo, Brasil.
Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.
Cad Saude Publica. 2020;36(5):e00230318. doi: 10.1590/0102-311x00230318. Epub 2020 Jun 1.
The aim of this study was to analyze self-rated health in Brazil's adult population according to markers of health inequality (color or race, region of residence, schooling, per capita household income, and social class), stratified by sex. We studied 59,758 individuals 18 years or older who participated in the 2013 National Health Survey, a population-based household survey. Data collection used face-to-face interviews and key physical measurements. Self-rated health was classified as positive, fair, or negative. Multinomial logistic regression was used to estimate crude and adjusted odds ratios (OR) and respective 95% confidence intervals (95%CI). Percentage agreement and kappa values were calculated to compare the results obtained by regression models and the expected values. Prevalence of positive self-rated health in the overall population was 66.2% (70% in men and 62.6% in women). In the adjusted analysis, the odds of worse self-rated health were significantly higher in individuals with lower per capita household income, less schooling, from the lowest social classes, residents of the North and Northeast regions, and those with brown and black color/race. Public policies for health promotion and recovery in these more vulnerable social groups can help reduce the persistent health inequalities in Brazil.
本研究旨在根据健康不平等指标（肤色或种族、居住地区、受教育程度、家庭人均收入和社会阶层），按性别分层，分析巴西成年人口的自评健康状况。我们研究了59758名18岁及以上参与2013年全国健康调查的个人，该调查是一项基于人群的家庭调查。数据收集采用面对面访谈和关键身体测量。自评健康分为积极、一般或消极。采用多项逻辑回归来估计粗比值比（OR）和调整后的比值比以及各自的95%置信区间（95%CI）。计算百分比一致性和kappa值，以比较回归模型得到的结果和预期值。总体人群中自评健康为积极的患病率为66.2%（男性为70%，女性为62.6%）。在调整分析中，家庭人均收入较低、受教育程度较低、来自最低社会阶层、居住在北部和东北部地区以及肤色或种族为棕色和黑色的个体，自评健康状况较差的几率显著更高。针对这些更脆弱社会群体的健康促进和康复公共政策有助于减少巴西持续存在的健康不平等现象。
