Disaggregating health inequalities within Rio de Janeiro, Brazil, 2002-2010, by applying an urban health inequality index

Bortz, Martin; Kano, Megumi; Ramroth, Heribert; Barcellos, Christovam; Weaver, Scott R.; Rothenberg, Richard; Magalhães, Monica

doi:10.1590/0102-311X00081214

home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

ARTICLE • Cad. Saúde Pública 31 (suppl 1) • Nov 2015 • https://doi.org/10.1590/0102-311X00081214 linkcopy

Disaggregating health inequalities within Rio de Janeiro, Brazil, 2002-2010, by applying an urban health inequality index

Desagregando desigualdades na saúde no Rio de Janeiro, Brasil, 2002-2010, através da aplicação de um índice urbano de desigualdade de saúde

Disgregando desigualdades en el ámbito de la salud en Río de Janeiro, Brasil, 2002-2010, mediante la aplicación de un índice urbano de desigualdad en salud

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

An urban health index (UHI) was used to quantify health inequalities within Rio de Janeiro, Brazil, for the years 2002-2010. Eight main health indicators were generated at the ward level using mortality data. The indicators were combined to form the index. The distribution of the rank ordered UHI-values provides information on inequality among wards, using the ratio of the extremes and the gradient of the middle values. Over the decade the ratio of extremes in 2010 declined relative to 2002 (1.57 vs. 1.32) as did the slope of the middle values (0.23 vs. 0.16). A spatial division between the affluent south and the deprived north and east is still visible. The UHI correlated on an ecological ward-level with socioeconomic and urban environment indicators like square meter price of apartments (0.54, p < 0.01), low education of mother (-0.61, p < 0.01), low income (-0.62, p < 0.01) and proportion of black ethnicity (-0.55, p < 0.01). The results suggest that population health and equity have improved in Rio de Janeiro in the last decade though some familiar patterns of spatial inequality remain.

Health Status Indicators; Health Inequalities; Urban Health

	2002	2003	2004	2005	2006	2007	2008	2009	2010
UHI
Ratio	1.57	1.55	1.54	1.50	1.50	1.40	1.35	1.34	1.35
Slope	0.23	0.23	0.22	0.22	0.22	0.21	0.20	0.19	0.18
Mean	0.77	0.78	0.79	0.79	0.79	0.80	0.81	0.82	0.82
SD	0.10	0.10	0.10	0.09	0.09	0.08	0.07	0.07	0.07
Min.	0.16	0.17	0.12	0.19	0.22	0.45	0.56	0.56	0.55
Max.	0.95	0.95	0.94	0.93	0.92	0.93	0.94	0.95	0.96
Range	0.79	0.78	0.81	0.74	0.70	0.48	0.38	0.39	0.41
Diabetes
Ratio	2.55	2.34	2.17	2.04	1.99	2.09	2.09	2.13	2.12
Slope	0.43	0.44	0.43	0.44	0.43	0.41	0.40	0.42	0.40
Ischaemic heart disease
Ratio	3.42	3.03	2.62	2.64	2.57	2.22	2.09	2.01	1.92
Slope	0.36	0.36	0.38	0.36	0.35	0.33	0.32	0.31	0.28
Breast and cervix cancer
Ratio	2.25	2.26	2.01	1.95	1.99	2.01	1.83	1.84	1.86
Slope	0.30	0.30	0.27	0.29	0.28	0.28	0.28	0.27	0.27
HIV
Ratio	1.54	1.52	1.43	1.42	1.42	1.38	1.38	1.39	1.42
Slope	0.19	0.19	0.19	0.17	0.17	0.16	0.16	0.16	0.16
Tuberculosis
Ratio	1.66	1.56	1.52	1.40	1.40	1.36	1.42	1.46	1.46
Slope	0.23	0.22	0.19	0.17	0.17	0.18	0.19	0.17	0.18
Infant mortality
Ratio	2.60	2.12	2.54	2.63	2.63	2.25	2.17	2.16	2.37
Slope	0.36	0.33	0.34	0.38	0.38	0.38	0.37	0.38	0.40
Traffic accident
Ratio	1.77	1.80	1.77	1.75	1.75	1.59	1.47	1.38	1.34
Slope	0.23	0.23	0.24	0.25	0.25	0.22	0.21	0.20	0.18
Homicide
Ratio	1.62	1.62	1.57	1.46	1.46	1.30	1.24	1.21	1.19
Slope	0.26	0.25	0.23	0.22	0.22	0.17	0.15	0.13	0.11

	Diabetes	Ischaemic heart disease	Breast and cervix cancer	Tuber- culosis	HIV	Traffic accident	Homicide	Infant mortality	UHI
Spearman
Distance from Lagoa	-0.46 *	-0.26 *	-0.078	-0.01	-0.10	-0.12	-0.40 *	-0.40 *	-0.30 *
Apartment price per square meter **	0.57 *	0.36 *	0.19 ***	0.37 *	0.27 *	0.25 *	0.58 *	0.53 *	0.54 *
Population growth ^#	-0.26 *	-0.045	0.13	0.04	0.01	-0.04	-0.14	-0.18 ***	-0.09
Pearson
Mothers aged < 20 years ^##	-0.56 *	-0.25 *	-0.15	-0.42 *	-0.32 *	-0.24 *	-0.56 *	-0.63 *	-0.61 *
Birth before week 37 ^##	-0.01	-0.13	-0.13	-0.16	-0.11	-0.05	-0.11	-0.04	-0.17
Mothers with 4-7 years of education ^##	-0.50 *	-0.27 *	-0.15	-0.49 *	-0.34 *	-0.29 *	-0.47 *	-0.58 *	-0.62 *
Mothers with > 12 years of education ^##	0.65 *	0.36 *	0.20 ***	0.43 *	0.35 *	0.30 *	0.55 *	0.62 *	0.66 *
Mothers with < 3 pre-natal consultations ^##	-0.48 *	-0.24 *	-0.13	-0.36 *	-0.27 *	-0.14	-0.43 *	-0.51 *	-0.51 *
Mothers with > 7 pre-natal consultations ^##	0.58 *	0.27 *	0.16	0.40 *	0.31 *	0.21 ***	0.49 *	0.59 *	0.59 *
Illiteracy ^#	-0.43 *	-0.06	-0.02	-0.36 *	-0.22 *	-0.13	-0.29 *	-0.48 *	-0.41 *
Persons with income < double mininum wage ^#	-0.61 *	-0.29 *	-0.17 ***	-0.43 *	-0.35 *	-0.25 *	-0.49 *	-0.58 *	-0.62 *
Persons with income 5-10 times mininum wage ^#	0.63 *	0.29 *	0.18 ***	0.40 *	0.31 *	0.22 ***	0.54 *	0.60 *	0.61 *
Black ^#	-0.51 *	-0.21 ***	-0.17 ***	-0.39 *	-0.24 *	-0.15	-0.46 *	-0.66 *	-0.55 *
White ^#	0.62 *	0.27 *	0.14	0.36 *	0.28 *	0.18 ***	0.53 *	0.66 *	0.60 *
Mulatto ^#	-0.62 *	-0.28 *	-0.11	-0.31 *	-0.27 *	-0.18 ***	-0.52 *	-0.60 *	-0.57 *
People aged > 60 years ^#	0.52 *	0.018 ***	0.03	0.23 *	0.17 ***	0.15	0.37 *	0.50 *	0.42 *
People aged < 20 years ^#	-0.57 *	-0.20 ***	-0.08	-0.31 *	-0.21 ***	-0.17	-0.44 *	-0.58 *	-0.50 *

vertical_align_top show_chart

more_horiz close
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Rua Leopoldo Bulhões, 1480 , 21041-210 Rio de Janeiro RJ Brazil, Tel.:+55 21 2598-2511, Fax: +55 21 2598-2737 / +55 21 2598-2514 - Rio de Janeiro - RJ - Brazil
E-mail: cadernos@ensp.fiocruz.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

[TFN1] * Statistically significant at p < 0.01 level (double-sided); ** Square meter price for apartment: source ZIS; *** Statistically significant at p < 0.05 level (double-sided); ^# IBGE census data, 2010; ^## SINASC data, 2010.