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      Estimates of hypertension and diabetes mellitus prevalence according to Health Vulnerability Index in Belo Horizonte, MG, Brazil Translated title: Estimativas de prevalência de hipertensão e diabetes mellitus segundo índice de vulnerabilidade da saúde em Belo Horizonte, MG, Brasil

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          Abstract

          ABSTRACT: Objective: To estimate the prevalences of hypertension and diabetes for small areas in Belo Horizonte, according to the Health Vulnerability Index (HVI). Methods: Ecological study with data from the Surveillance of Risk and Protection Factors for Chronic Diseases by Telephone Survey (Vigitel) conducted in Belo Horizonte, from 2006 to 2013. The self-reported diagnosis of diabetes and hypertension were evaluated. The estimates of prevalence and the 95% confidence interval (95%CI) were calculated using the direct and indirect method by HVI grouped into four categories: low, medium, high and very high health risk. Results: During the period evaluated, 26% (95%CI 25.2 – 26.8) and 6.1% (95%CI 6.7 – 6.5) of the adult population from Belo Horizonte reported being hypertensive and diabetic, respectively. According to the indirect method to obtain estimates of hypertension and diabetes prevalences per HVI, it was found that areas of very high risk had a higher prevalence of adults with hypertension (38.6%; 95%CI 34.8 – 42.4) and diabetes (16.2%; 95%CI 13.1 – 19.3) when compared to the low risk (28.2%; 95%CI 27.0 – 29.4 and 6%; 95%CI 5.4 – 6.7, respectively). Conclusion: The adult population living in areas at high risk for health had a higher prevalence of hypertension and diabetes compared to those with a lower risk.

          Translated abstract

          RESUMO: Objetivo: Estimar as prevalências de hipertensão e diabetes para pequenas áreas em Belo Horizonte, MG, segundo o índice de vulnerabilidade da saúde (IVS). Métodos: Estudo ecológico com dados do sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico realizado em Belo Horizonte, nos anos de 2006 a 2013. Foi avaliado o diagnóstico autorreferido de diabetes e de hipertensão. As estimativas de prevalência e o intervalo de 95% de confiança (IC95%) foram calculados, segundo IVS, usando os métodos de estimação direto e indireto para pequenas áreas. Resultados: Durante o período avaliado, 26 (IC95% 25,2 – 26,8) e 6,1% (IC95% 6,7 – 6,5) da população adulta de Belo Horizonte reportaram ser hipertensos e diabéticos, respectivamente. Segundo o método indireto para obtenção das estimativas de hipertensão e diabetes por IVS, verificou-se que as áreas de risco muito elevado apresentaram maior prevalência de adultos com hipertensão (38,6%; IC95% 34,8 – 42,4) e diabetes (16,2%; IC95% 13,1 – 19,3) quando comparadas com as de baixo risco (28,2%; IC95% 27,0 – 29,4) e (6%; IC95% 5,4 – 6,7), respectivamente. Conclusão: A população de adultos residentes em áreas com risco elevado à saúde apresentou maiores prevalências de hipertensão e diabetes em comparação àquelas com menor risco.

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          Noncommunicable diseases.

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            Mortality due to noncommunicable diseases in Brazil, 1990 to 2015, according to estimates from the Global Burden of Disease study : Mortalidade por doenças não transmissíveis no Brasil, 1990 a 2015, segundo estimativas do estudo de Carga Global de Doenças

            CONTEXT AND OBJECTIVE: Noncommunicable diseases (NCDs) are the leading health problem globally and generate high numbers of premature deaths and loss of quality of life. The aim here was to describe the major groups of causes of death due to NCDs and the ranking of the leading causes of premature death between 1990 and 2015, according to the Global Burden of Disease (GBD) 2015 study estimates for Brazil. DESIGN AND SETTING: Cross-sectional study covering Brazil and its 27 federal states. METHODS: This was a descriptive study on rates of mortality due to NCDs, with corrections for garbage codes and underreporting of deaths. RESULTS: This study shows the epidemiological transition in Brazil between 1990 and 2015, with increasing proportional mortality due to NCDs, followed by violence, and decreasing mortality due to communicable, maternal and neonatal causes within the global burden of diseases. NCDs had the highest mortality rates over the whole period, but with reductions in cardiovascular diseases, chronic respiratory diseases and cancer. Diabetes increased over this period. NCDs were the leading causes of premature death (30 to 69 years): ischemic heart diseases and cerebrovascular diseases, followed by interpersonal violence, traffic injuries and HIV/AIDS. CONCLUSION: The decline in mortality due to NCDs confirms that improvements in disease control have been achieved in Brazil. Nonetheless, the high mortality due to violence is a warning sign. Through maintaining the current decline in NCDs, Brazil should meet the target of 25% reduction proposed by the World Health Organization by 2025. CONTEXTO E OBJETIVO: As doenças crônicas não transmissíveis (DCNT) são o principal problema de saúde global e geram um elevado número de mortes prematuras e perda de qualidade de vida. O objetivo foi descrever os principais grupos de causas de morte por DCNT e o ranking das causas de morte prematura entre 1990 a 2015, segundo estimativas do estudo Global Burden of Disease (GBD) 2015 para o Brasil. TIPO DE ESTUDO E LOCAL: Estudo transversal do Brasil e 27 Unidades Federadas. MÉTODOS: Estudo descritivo das taxas de mortalidade por DCNT, com correções para sub-registro e códigos garbage . RESULTADOS: O estudo aponta a transição epidemiológica no Brasil entre 1990 e 2015, com o crescimento da mortalidade proporcional por DCNT, seguida das violências, e com a redução das causas maternas, infecciosas e infantis na carga global de doenças. As DCNT cursaram com as taxas de mortalidade mais elevadas em todo o período, mas com declínio para as doenças cardiovasculares, respiratórias crônicas e câncer. O diabetes aumentou no período. As DCNT lideram entre as causas de morte prematura (30 a 69 anos): doenças isquêmicas do coração e doenças cerebrovasculares, seguidas de violência interpessoal, lesão no trânsito e HIV/aids. CONCLUSÕES: A queda da mortalidade por DCNT confirma melhora do controle de doenças no país. Entretanto, a alta mortalidade por violência é um sinal de alerta. Mantendo-se a queda atual das DCNT, o Brasil deverá atingir as metas de redução propostas pela Organização Mundial de Saúde de 25% até 2025.
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              Inequalities in health care among patients with type 2 diabetes by individual socio-economic status (SES) and regional deprivation: a systematic literature review

              Introduction Quality of care could be influenced by individual socio-economic status (SES) and by residential area deprivation. The objective is to synthesize the current evidence regarding inequalities in health care for patients with Type 2 diabetes mellitus (Type 2 DM). Methods The systematic review focuses on inequalities concerning process (e.g. measurement of HbA1c, i.e. glycolised haemoglobin) and intermediate outcome indicators (e.g. HbA1c level) of Type 2 diabetes care. In total, of n = 886 publications screened, n = 21 met the inclusion criteria. Results A wide variety of definitions for ‘good quality diabetes care’, regional deprivation and individual SES was observed. Despite differences in research approaches, there is a trend towards worse health care for patients with low SES, concerning both process of care and intermediate outcome indicators. Patients living in deprived areas less often achieve glycaemic control targets, tend to have higher blood pressure (BP) and worse lipid profile control. Conclusion The available evidence clearly points to the fact that socio-economic inequalities in diabetes care do exist. Low individual SES and residential area deprivation are often associated with worse process indicators and worse intermediate outcomes, resulting in higher risks of microvascular and macrovascular complications. These inequalities exist across different health care systems. Recommendations for further research are provided.
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                Author and article information

                Journal
                rbepid
                Revista Brasileira de Epidemiologia
                Rev. bras. epidemiol.
                Associação Brasileira de Saúde Coletiva (Rio de Janeiro, RJ, Brazil )
                1415-790X
                1980-5497
                2021
                : 24
                : suppl 1
                : e210015
                Affiliations
                [2] Belo Horizonte Minas Gerais orgnameUniversidade Federal de Minas Gerais orgdiv1School of Nursing Brazil
                [1] Belo Horizonte Minas Gerais orgnameUniversidade Federal de Minas Gerais orgdiv1School of Medicine Brazil
                [4] Belo Horizonte Minas Gerais orgnameUniversidade Federal de Minas Gerais orgdiv1Hospital das Clínicas and School of Medicine Brazil
                [3] Belo Horizonte Minas Gerais orgnameUniversidade Federal de Minas Gerais orgdiv1School of Nursing orgdiv2Department of Maternal and Child Nursing and Public Health Brazil
                Article
                S1415-790X2021000200417 S1415-790X(21)02400000417
                10.1590/1980-549720210015.supl.1
                33886888
                781df2d2-04d8-4d6f-98c4-11fc8ffa3ad7

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 12 December 2020
                : 20 October 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 28, Pages: 0
                Product

                SciELO Brazil

                Categories
                Original Articles

                Modelos logísticos,Inquéritos epidemiológicos,Análise de pequenas áreas,Diabetes mellitus,Health surveys,Hipertensão,Small-area analysis,Logistic models,Hypertension

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