Determinantes da incapacidade funcional de idosos da cidade de São Paulo na perspectiva étnico-racial

Content Provider	Semantic Scholar
Author	Silva, Alexandre Evangelista
Copyright Year	2017
Abstract	Introduction: In Brazil, social inequality is a problem that needs more effective confrontation and respect for the specific characteristics of the different social groups. Aging in the city of São Paulo, from an ethnic-racial perspective, is still little known and it is not known how the social determinants of health influence health outcomes that population. Measuring functional disability in the elderly is a universally accepted indicator for diagnosing health conditions. The present study raises the hypothesis that there are differences in the prevalence of functional disabilities among elderly people of different racial strata. Objectives: To identify the determinants of the functional incapacity of the elderly, considering the race / skin color and to describe the profiles of functional incapacities of the elderly according to covariates on demographic, socioeconomic and way of life conditions, from the ethno-racial perspective and functional disability. Method: A cross-sectional study was carried out using the 2010 cohort of the Health and Welfare and Aging Study (SABE), considering three outcomes for the dependent variable on functional disability: functional mobility deficit, difficulty in Basic Activities and in Instrumental Activities of Daily Living (BADL and IADL, respectively). The variable of analysis was race / skin color and the independent variables were the demographic, socioeconomic and way of life characteristics. For the statistical analysis, the chi-square test with the Rao-Scott correction and Poisson regression models (for the variable race color categorized in blacks and whites) and multinomial logistic regression (for the categorized race / color variable in black, brown/pardos and white). The measure of association chosen was the Prevalence Ratio (PR). Results: A total of 1263 elderly people were considered for this analysis: 62% whites, 30.9% pardos and 7.1% blacks who, after weighting procedures, represented the population of 1,244,372 elderly people, of which 771,510 whites, 384,511 pardos and 88,350 blacks from the city of São Paulo. Demographic, socioeconomic and way of life characteristics showed statistically significant differences and worse for blacks and pardos, most of the time. Being female, 80 or older, widowed, unable to read or write, having low schooling (up to 4 years of schooling), not working and never inviting people to come to their home or go out to public places were conditions statistically associated with functional mobility deficit or with difficulty in one or more BADL or IADL. In the regression models, being black had greater PR in the mobility deficit and difficulty in 2 or more IADL, whereas PR was higher in brown people when the outcome was difficulty in 2 or more BADL. Discussion: Differences could not be explained solely by the demographic, socioeconomic and lifestyle conditions of the different racial groups, suggesting that health inequity and health racism were present in the systematic inequalities found among the racial groups assessed. Conclusion: The inequalities found among the racial categories pointed to systematic situations of disadvantages for brown elderly and, mainly, for black elderly. Racism and inequity in health were the explanatory conditions of these inequalities.
File Format	PDF HTM / HTML
DOI	10.11606/T.6.2017.tde-05072017-100217
Alternate Webpage(s)	https://teses.usp.br/teses/disponiveis/6/6143/tde-05072017-100217/publico/AlexandreDaSilvaREVISADA.pdf
Alternate Webpage(s)	https://doi.org/10.11606/T.6.2017.tde-05072017-100217
Language	English
Access Restriction	Open
Content Type	Text
Resource Type	Article