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In Brazil, infant and child mortalityreveal a downward trend. Few studies have investigatedthe temporal trends in the inequalitiesof these deaths, at individual level, according tosocio-economic status. The scope of this articlewas to investigate the temporal trends of the magnitudeof inequalities in infant and child mortality,between groups defined by maternal educationand household income per capita in the1993-2008 period in Brazil. Microdata from theNational Household Sample Survey wereused. The inequality measure was the concentrationindex (CI). It was calculated for infant andchild deaths, according to maternal educationand household income per capita. During the2003-2008 period, there was a reduction in inequalitiesin infant and child mortality, at individuallevel, and according to maternal educationand household income per capita. In 2008,the concentration of child deaths among childrenwhose mothers had less education was higher thanthe concentration of infant deaths. The CI accordingto income had greater variability, butalso demonstrated a lower concentration of deathsat the end of the period. The measurement of inequalitiesin health is important for monitoringthe population health situation.


Garcia L.P.,Institute Pesquisa Economica Aplicada | Hofelmann D.A.,Vale do Itajai University | Facchini L.A.,Federal University of Pelotas
Cadernos de Saude Publica | Year: 2010

This cross-sectional study with 1,249 workers from all 49 municipal primary health care centers was conducted in Florianópolis, Santa Catarina State, Brazil, with the objective of investigating the prevalence of poor self-rated health and its association with working conditions and other factors. Multivariate statistical analyses were conducted using Poisson regression. The prevalence of poor self-rated health was 21.86% (95%CI: 19.56%-24.15%). The largest prevalence was found among dental assistants (35.71%), and the lowest among physicians (10.66%). In the adjusted analysis, the outcome was associated with female gender (PR = 1.48; 95%CI: 1.03- 2.14), older age (PR = 1.29; 95%CI: 1.05-1.59), higher education (PR = 0.69; 95%CI: 0.55-0.87), more time working at the primary care center (PR = 1.57; 95%CI: 1.29-1.98), higher workload score (PR = 1.67; 95%CI: 1.35-2.05), obesity (PR = 1.74; 95%CI: 1.37-2.21), and often or always experiencing musculoskeletal symptoms (PR = 2.69; 95%CI: 1.90-3.83). A higher workload score remained associated with the outcome, suggesting an association between working conditions and self-rated health.


Camarano A.A.,Institute Pesquisa Economica Aplicada | Carvalho D.F.,Institute Pesquisa Economica Aplicada
Ciencia e Saude Coletiva | Year: 2015

Reduced participation of the male population in economic activities is the result of their later entry and earlier leave from the labor market. This earlier exit is not only associated to “early” retirement. Between 1993 and 2013, there was an increase in the number of men aged 50-59 who were not working, not looking for a job, and were not retired (NER). The literature stresses that work is the most important social event of a man’s life, and the traditional gender contract establishes the breadwinner role for men and the caregiver one for women. This growth suggests changes in gender relations since a decrease was observed in the proportion of male household heads, and an increase in that of male spouses, and of those living with their parents. This may be a consequence of their difficulties in participating in the labor market, also given their low education level; therefore, requiring greater participation from women. This trend is contradictory with the new demographic regime. A later leave from economic activities is an important requirement to minimize the challenges brought about by the reducing workforce and aging population. © 2015, Associacao Brasileira de Pos - Graduacao em Saude Coletiva. All rights reserved.


Murray J.,University of Cambridge | Cerqueira D.R.D.C.,Institute Pesquisa EconOmica Aplicada | Kahn T.,Fundacao de Estudos e Formacao Politica do Partido Social Democratico
Aggression and Violent Behavior | Year: 2013

Between 1980 and 2010 there were 1. million homicides in Brazil. Dramatic increases in homicide rates followed rises in inequality, more young men in the population, greater availability of firearms, and increased drug use. Nevertheless, disarmament legislation may have helped reduce homicide rates in recent years. Despite its very high rate of lethal violence, Brazil appears to have similar levels of general criminal victimization as several other Latin American and North American countries. Brazil has lower rates of drug use compared to other countries such as the United States, but the prevalence of youth drug use in Brazil has increased substantially in recent years. Since 1990, the growth of the Brazilian prison population has been enormous, resulting in the fourth largest prison population in the world. Through a systematic review of the literature, we identified 10 studies assessing the prevalence of self-reported offending in Brazil and 9 studies examining risk factors. Levels of self-reported offending seem quite high among school students in Brazil. Individual and family-level risk factors identified in Brazil are very similar to those found in high-income countries. © 2013 The Authors.


Marinho A.,Institute Pesquisa Economica Aplicada | Cardoso S.S.,Institute Pesquisa Economica Aplicada | de Almeida V.V.,Institute Pesquisa Economica Aplicada
Cadernos de Saude Publica | Year: 2010

This study focuses on organ transplantation in Brazilian States in the years 2004, 2005, and 2006. Average waiting times were estimated by queueing theory models. We found that average waiting time for transplantation decreased for cornea and pancreas, increased for liver, heart, and kidney/pancreas, and varied erratically for kidney and lung. We also detected broad disparities in waiting times between States. Mean waiting time was shortest in the States of South, Southeast, and Midwest Brazil. These same States also showed the highest transplantation rates in the country.


Freitas L.R.S.,University of Brasilia | Duarte E.C.,University of Brasilia | Garcia L.P.,Institute Pesquisa Economica Aplicada
BMC Infectious Diseases | Year: 2016

Background: Leprosy incidence has reduced in recent years in Brazil, although the disease still persists as a public health problem in some regions. To investigate the trends of selected leprosy indicators in Brazilian municipalities with high risk of transmission is essential to provide effective control of the disease, yet this area has not been investigated. Methods: This is an ecological time-series study with multiple groups using Notifiable Diseases Information System (SINAN) data. All 692 municipalities of the states of Mato Grosso, Tocantins, Rondônia, Pará and Maranhão were included. The incidence rates of leprosy were calculated, as well as incidence rates in children under 15 years per 100,000 inhabitants and rates of new cases presenting grade-2 disabilities per 100,000 inhabitants. Joinpoint Regression was used to analyse the time trends of the different indicators studied. The spatial distribution of temporal variations of the indicators in the period was presented. Results: Between 2001 and 2012, 176,929 leprosy cases were notified in the area studied, this being equivalent to 34.6 % of total cases in Brazil. In the aggregate of municipalities, there was a reduction in incidence rate of leprosy from 89.10 to 56.98 new cases per 100,000 inhabitants between 2001 and 2012, with a significant reduction between 2003 and 2012 (APC: - 6.2 %, 95 % CI: -7.2 % to -5.2 %). The incidence rate in <15 years also reduced significantly between 2003 and 2012 (APC: -5.6 %; 95 % CI: -7.2 % to -4.1 %). The rate of new cases with grade 2 disability remained stable between 2001 and 2012 (APC: -1.3 %; 95 % CI: -2.6 % to 0.1 %). Conclusion: Despite the reduction in the leprosy incidence rate, strategies for controlling this disease need to be enhanced to enable early case detection, especially in hyperendemic municipalities, in order to prevent disability. © 2016 The Author(s).


Osorio R.G.,Institute Pesquisa Economica Aplicada | Servo L.M.S.,Institute Pesquisa Economica Aplicada | Piola S.F.,Institute Pesquisa Economica Aplicada
Ciencia e Saude Coletiva | Year: 2011

Herein, unmet health care needs, defined by the authors as the situation when an individual feels the need but does not seek healthcare, are studied from the data of the health questionnaires of the 1998, 2003 and 2008 rounds of the National Household Sampling Survey (Pnad). From 1998 to 2008, the percentage of the population with healthcare needs during the two weeks prior to the interview did not change, remaining at around 17%, whilst the share with unmet healthcare needs fell from 3.5% to 2.9%. There were also changes in the reasons chosen by the interviewees to justify why they did not seek healthcare. The percentage of those who said they could not afford it decreased - though it is still the reason given most frequently - thereby boosting the percentages of those alleging problems with the healthcare system, such as long waiting times and a lack of professionals and services. People with less income or schooling, residing in the poorer regions of the country or in rural areas, blacks, males, adults, workers, people living with other people with unmet healthcare needs or that have not been to an appointment with a doctor in the last year, and those without health plans, are less likely to seek healthcare and therefore stand a higher chance of having unmet healthcare needs.


This texts aims to introduce some reflections on the role and relevance of health economics units (HEUs) regarding national health care systems. The starting points are the core aspects of this knowledge field and its contribution to health care management, to give rise to considerations on the role and relevance of such units. Matters such as the health care managers’ and political leaders’ knowledge on health economics, the need for HEUs to take simultaneous action at various levels in the organization of a qualified multidisciplinary technical body, as well as the technical and political nature of the work, their possibilities and limits for action, their aspects, and their relationship with external research groups. Finally, the work of a specialized internal health economics team is one of the means to qualify the decision-making process in public health care organizations, to optimize the use of resources and their proper equitable allocation. © 2016, UNIV SAOPAULO. All rights reserved.


Reis M.,Institute Pesquisa Economica Aplicada
Health Economics | Year: 2012

Empirical evidence indicates that children living in wealthier households have better health. Food insecurity could be related to lack of adequate nutrition experienced by poor children and may be pointed out as one of the possible explanations for this relationship. This paper investigates the association between food insecurity and children's health and nutrition and the role of the former in the child health income gradient. Using data from the 2006 Brazilian Demographic and Health Survey, the results show that children living in households with food insecurity have worse nutrition and health indicators. In addition, the relationship between household income and many children's health and nutrition measures weakens but remains significant when controlling for food insecurity. © 2011 John Wiley & Sons, Ltd.


Saccaro N.L.,Institute Pesquisa Economica Aplicada
Ambiente e Sociedade | Year: 2011

This report discusses the evolution of national and international rules which control the access to genetic resources and the way of sharing their benefits. A panorama with the main points of conflict, the fails in legislation and the pre-existing initiatives to solve them was outlined, highlighting the important role of Brazil in this work.

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