Impact of the Social Agendas - Agenda 21 and Healthy Cities - upon Social Determinants of Health in Brazilian municipalities: measuring the effects of diffuse social policies through the dimensions of the Millennium Development Goals

Revista Brasileira de Epidemiologia

Baltar, Valéria Troncoso³  Minowa, Evelin⁴  Moreira, Rafael da Silveira²  Moysés, Simone Tetu¹  Westphal, Marcia Faria⁴  Zioni, Fabiola⁴  Nascimento, Paulo Roberto do⁴ 

[1] Pontifícia Universidade Católica do Paraná, Curitiba, Brazil;Fundação Oswaldo Cruz, Recife, Brazil;Universidade Federal Fluminense, Niterói, Brazil;Universidade de São Paulo, São Paulo, Brazil

关键词: Health Promotion;    Quantitative research methods;    Healthy Cities;    Agenda 21;    Millennium Development Goals;    Social Determinants of Heath;   

DOI  :  10.1590/1809-4503201400060001

学科分类：过敏症与临床免疫学

来源: SciELO

【 摘 要 】

INTRODUCTION: In order to improve the quality of life and health of the population in recent years there have been several local social agendas, like Agenda 21 and Healthy Cities. OBJECTIVES: To identify how social agendas are impacting on the living conditions and health in municipalities of the five regions of Brazil. METHODS: Through an ecological longitudinal study, the social agendas' effects on the Social Determinants of Health were measured in 105 municipalities, using indicators related to the eight dimensions of the Millennium Development Goals (MDGs). Indicators were also calculated for other 175 non-exposed municipalities. Descriptive statistics were calculated for each group of municipalities at three different moments: in the year of the agenda implementation, then 3 and 6 years later. The models were adjusted by the method of GEE to assess the effects of the agendas, time and their interaction. Nonparametric analysis of variance was used for the ordinal data with repeated measures. RESULTS: Impacts of the agendas were detected for reduction of hunger and increase of universal access to education: 'percentage of children under one year with protein/caloric undernourishment' (interaction effect: p = 0.02) and 'Age-grade distortion in the 8th grade of fundamental education' (interaction effect: p < 0.001). CONCLUSION: The comparative discussion between model results and descriptive statistics recommends, at further research, extending the period of investigation, using compound indexes, improving the methodology for the apprehension of the impacts of the diffuse social policies for development, as well as using 'mixed methodologies', integrating quantitative and qualitative tools.

【 授权许可】

Unknown