Akerman M, Campanario P, Maia P B
Centro de Estudos de Cultura Contemporânea. São Paulo, Brasil.
Rev Saude Publica. 1996 Aug;30(4):372-82. doi: 10.1590/s0034-89101996000400011.
A field study undertaken in the city of S. Paulo is presented as part of the project Environment and Health in Developing Countries: An Analysis of Intra-Urban Differentials Using Existing Data financed by the Ministry of Foreign Affairs of the United Kingdom with academic support from the London School of Hygiene and Tropical Medicine (LSHTM). The research aim was to fill in the gaps in the information needed to establish associations between mortality, urbanization and the environment. Statistics were produced by means of existing data collected by city departments, research carried out by universities and census data. Data quality was assessed taking into consideration data coverage, accuracy, and sensibility to pinpoint deprived areas in the city of S. Paulo. Socioeconomic data were used to create a composite index for districts and subdistrict in order to form four socioeconomic zones. Mortality differentials between the zones by five broad age groups (0-4, 5-14, 15-44, 45-64 e 65+) and four ICD chapters (circulatory, respiratory, infectious and parasitic and external causes) are presented. The zoning used showed that 43.8% of S. Paulo residents live in areas under the worst socioeconomic conditions. Health data demonstrated that people living in this areas had higher rates of mortality then those living in the areas with the best conditions. Finally, excess mortality data are analyzed and suggested as a good method for allocating health resources.
作为“发展中国家的环境与健康:利用现有数据对城市内部差异进行分析”项目的一部分,本文展示了在圣保罗市开展的一项实地研究。该项目由英国外交部资助,伦敦卫生与热带医学院(LSHTM)提供学术支持。研究目的是填补在建立死亡率、城市化与环境之间关联所需信息方面的空白。统计数据通过城市部门收集的现有数据、大学开展的研究以及人口普查数据得出。在评估数据质量时,考虑了数据覆盖范围、准确性以及在圣保罗市精准定位贫困地区的敏感性。利用社会经济数据为各行政区和分区创建了一个综合指数,以形成四个社会经济区域。展示了五个广泛年龄组(0 - 4岁、5 - 14岁、15 - 44岁、45 - 64岁和65岁以上)以及国际疾病分类(ICD)的四个章节(循环系统、呼吸系统、传染病和寄生虫病以及外部原因)在各区域之间的死亡率差异。所采用的分区显示,43.8%的圣保罗居民生活在社会经济条件最差的地区。健康数据表明,生活在这些地区的人的死亡率高于生活在条件最佳地区的人。最后,对超额死亡率数据进行了分析,并建议将其作为分配卫生资源的一种良好方法。