RESUMO

The aim of this study was to verify the use of outpatient health services and associated factors among women ages 20 to 60 years living in the urban area of São Leopoldo, Rio Grande do Sul State, Brazil. This was a cross-sectional, population-based study with a sample of 1,026 women in 2003. The association between the independent variables and the outcome was evaluated by means of prevalence ratios and 95% confidence intervals (95%CI). Poisson regression was used with a hierarchical model. Among 1,022 women, 136 (13.3%; 95%CI: 11.2-15.4) had not used outpatient services in the 12 months prior to the interview. Women in lower socioeconomic classes (C, D, and E), with less schooling, and with lower income showed lower use of outpatient health services. Thus, the most vulnerable women and those with the greatest health needs showed the lowest use of health services, suggesting unfavorable conditions in the local health system and pointing to the presence of lack of universal care and equal access.

Assuntos

RESUMO

O objetivo do estudo foi verificar a utilização dos serviços ambulatoriais de saúde e fatores associados pelas mulheres de 20 a 60 anos, residentes na zona urbana de São Leopoldo, Rio Grande do Sul, Brasil. Foi um estudo transversal de base populacional, incluindo 1.026 mulheres, no ano 2003. A associação entre as variáveis e o desfecho foi avaliada por meio das razões de prevalência e dos intervalos de 95 por cento de confiança (IC95 por cento). A regressão de Poisson foi utilizada segundo modelo hierarquizado. Entre 1.022 mulheres, 136 (13,3 por cento; IC95 por cento: 11,2-15,4) não utilizaram os serviços ambulatoriais de saúde nos últimos 12 meses que precederam a entrevista. Demonstrou-se que as mulheres inseridas nas classes econômicas C, D e E, com menos anos de estudo e com renda mais baixa apresentaram menor utilização dos serviços de saúde. Assim, as mulheres com maiores necessidades e mais vulneráveis apresentaram menor utilização dos serviços de saúde, sugerindo condições desfavoráveis no sistema de saúde local, apontando para a presença de falta de universalidade e iniqüidade no acesso.

The aim of this study was to verify the use of outpatient health services and associated factors among women ages 20 to 60 years living in the urban area of São Leopoldo, Rio Grande do Sul State, Brazil. This was a cross-sectional, population-based study with a sample of 1,026 women in 2003. The association between the independent variables and the outcome was evaluated by means of prevalence ratios and 95 percent confidence intervals (95 percentCI). Poisson regression was used with a hierarchical model. Among 1,022 women, 136 (13.3 percent; 95 percentCI: 11.2-15.4) had not used outpatient services in the 12 months prior to the interview. Women in lower socioeconomic classes (C, D, and E), with less schooling, and with lower income showed lower use of outpatient health services. Thus, the most vulnerable women and those with the greatest health needs showed the lowest use of health services, suggesting unfavorable conditions in the local health system and pointing to the presence of lack of universal care and equal access.

Assuntos

RESUMO

This study focused on the association between dietary patterns and obesity. A cross-sectional population-based study was performed in 1,026 adult women from Southern Brazil. Waist circumference (WC), height, and weight were measured according to a standardized protocol, and body mass index (BMI) was calculated. Obesity was defined as BMI > 30kg/m(2) and WC > 88cm. Principal components analysis was used to identify dietary patterns. Multivariate analysis used a Poisson regression model to estimate prevalence ratios and respective confidence intervals. After controlling for possible confounders, low consumption of "vegetables" protected against increased BMI (PR = 0.64; 95%CI: 0.47-0.86; p = 0.004), while low consumption of "nuts/oilseeds" protected against increased WC (PR = 0.93; 95%CI: 0.89-0.98; p = 0.008). Low consumption of "fruits" was a risk factor for high BMI (PR = 2.18; 95%CI: 1.35-3.53; p = 0.001). The study indicates the complexity of the association between dietary patterns and obesity. New studies are needed to further clarify the subject.

Assuntos

RESUMO

Com objetivo de estudar a associação de padrões alimentares com obesidade, realizou-se estudo transversal de base populacional com amostra representativa de 1.026 mulheres (20 a 60 anos) em São Leopoldo, Rio Grande do Sul, Brasil. A obesidade geral foi avaliada pela utilização de índice de massa corporal (IMC > 30kg/m²) e a adiposidade abdominal, circunferência da cintura (CC> 88cm). Os padrões alimentares foram identificados por análise fatorial. Para análise multivariada, foi utilizada regressão de Poisson. Entre o total de mulheres, 18 por cento (IC95 por cento: 15,66-20,53) tinham obesidade geral e 23,3 por cento (IC95 por cento: 20,72-26,06) abdominal. Após controle para fatores de confusão, o baixo consumo do PA-frutas associou-se positivamente com o IMC (RP = 2,18; IC95 por cento: 1,35-3,53; p = 0,001). Já o baixo consumo do PA-vegetais apresentou efeito protetor para o aumento nos níveis de IMC (RP = 0,64; IC95 por cento: 0,47-0,86; p = 0,004) e o do PA-nozes/oleaginosas para o aumento na medida da CC (RP = 0,93; IC95 por cento: 0,89-0,98; p = 0,008). O estudo aponta para a complexidade envolvida na relação entre padrões alimentares e obesidade e a necessidade de novos estudos, objetivando o melhor entendimento do tema.

This study focused on the association between dietary patterns and obesity. A cross-sectional population-based study was performed in 1,026 adult women from Southern Brazil. Waist circumference (WC), height, and weight were measured according to a standardized protocol, and body mass index (BMI) was calculated. Obesity was defined as BMI > 30kg/m² and WC > 88cm. Principal components analysis was used to identify dietary patterns. Multivariate analysis used a Poisson regression model to estimate prevalence ratios and respective confidence intervals. After controlling for possible confounders, low consumption of vegetables protected against increased BMI (PR = 0.64; 95 percentCI: 0.47-0.86; p = 0.004), while low consumption of nuts/oilseeds protected against increased WC (PR = 0.93; 95 percentCI: 0.89-0.98; p = 0.008). Low consumption of fruits was a risk factor for high BMI (PR = 2.18; 95 percentCI: 1.35-3.53; p = 0.001). The study indicates the complexity of the association between dietary patterns and obesity. New studies are needed to further clarify the subject.

Assuntos