Social inequalities between neighborhoods and cardiovascular disease: a multilevel analysis in a Latin American city

Ciencia e Saude Coletiva

article

Perner, Mónica Serena¹  Alazraqui, Marcio¹  Amorim, Leila D.² 

[1] Universidade Nacional de Lanús;Universidade Federal da Bahia

关键词: Cardiovascular diseases;    Inequalities;    Multilevel analysis;    Urban health;    Diabetes;   

DOI  :  10.1590/1413-81232022277.21662021

学科分类：社会科学、人文和艺术（综合）

来源: Associacao Brasileira de Pos - Graduacao em Saude Coletiva

【 摘 要 】

Studies analyzing relations between cardiovascular diseases (CVDs) and environmental aspects in Latin American cities are relatively recent and limited, since most of them are conducted in high-income countries, analyzing mortality outcomes, and comprising large areas. This research focuses on adults with diabetes and/or hypertension under clinical follow-up who live in deprived areas. At the individual level we evaluated sociodemographic and cardiovascular risk factors from patient’s records, and at the neighborhood level, socioeconomic conditions from census data. A multilevel analysis was carried out to study CVD. More women than men were under clinical follow-up, but men had higher frequency, higher odds, and shorter time to CVD diagnosis. Multilevel analysis showed that residing in neighborhoods with worst socioeconomic conditions leads to higher odds of CVDs, even after controlling for individual variables: OR (CI95%) of CVD in quartile 2 (Q2) 3.9 (1.2-12.1); Q3 4.0 (1.3-12.3); Q4 2.3 (0.7-8.0) (vs. highest socioeconomic level quartile). Among individuals living in unequal contexts, we found differences in CVD, which makes visible inequalities within inequalities. Differences between women and men should be considered through a gender perspective.

【 授权许可】

CC BY