Social Determinants of Health among children aged between 5
               and 9 years within the urban area, Sobral, Ceará, Brazil

Sucupira, Ana Cecília Silveira Lins; Andrade, Luiz Odorico Monteiro de; Barreto, Ivana Cristina Holanda Cunha; Lima, José Wellington; Santiago, Anna Vicente; Santiago, Adriana Xavier

doi:10.1590/1809-4503201400060014

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Original Articles • Rev. bras. epidemiol. 17 (Suppl 2) • 2014 • https://doi.org/10.1590/1809-4503201400060014 copy

Social Determinants of Health among children aged between 5 and 9 years within the urban area, Sobral, Ceará, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

INTRODUCTION:

In the district of Sobral, for the decade of 2000 at the same time that political measures were implanted towards the decrease of children mortality, discussions have begun about health and educations conditions, as well as life quality of children aged between 5 and 9, which is an age group of lesser vulnerability as far as health goes, although of major importance in the development of healthy habits and for the child's development itself.

OBJECTIVE:

Based on such scenario, it was set up a cohort of children aged between 5 and 9 and residents of the urban area of the district in order to study health and education conditions and quality of life which are essential for the future of these children in light of the Social Determinants of Health.

METHODS:

This is a cross-sectional study with a cohort of children born from 1990 to 1994, home interviews, clinical evaluation and lab exams. The structure for the development of the research was elaborated based on the model of attention towards the health of Family Health Strategy. In this report, the results of such home interviews shall be presented in regards to socio-demographic and environmental conditions in general, with a more detailed analysis of life styles, educational levels, child labor, nutrition and the use of health services by children.

Social determinants; School failure; Child labor; Use of health services; Nutrition; Family Health

	Frequency	%
Year of birth
1990	689	20.0
1991	709	20.6
1992	689	20.0
1993	688	20.0
1994	669	19.4
Gender
Male	2.722	50
Female	2.722	50
Race
Black/Mulatto/Brown	2.497	72.5
White	935	27.1
Asian	4	0.1
Indigenous	2	0.1
No answer	6	0.2

Social facilities in the surroundings	Freq.	%	Social facilities frequency of use	Freq.	%
Church or temple
Yes	2679	77.8	Always	1961	56.9
No	742	21.6	Sometimes	1347	39.1
NA	23	0.7	Never	133	3.9
			NA	3	0.1
Residents association
Yes	1598	46.4	Always	192	5.6
No	1129	32.5	Sometimes	346	10.0
NA	727	21.1	Never	2532	73.5
			NA	204	10.9
Sports club
Yes	968	28.1	Always	232	6.7
No	1940	56.4	Sometimes	474	13.8
NA	536	15.5	Never	2534	73.6
			NA	204	5.9
Public park
Yes	2267	65.8	Always	389	11.3
No	1050	30.5	Sometimes	769	22.3
NA	127	3.7	Never	2236	65.0
			NA	50	1.5
Supermarket or grocery store
Yes	3214	93.3	DNA**
No	224	6.5	DNA**
NA	6	0.2	DNA**
			DNA**
Bar
Yes	2917	84.7	Always	189	5.5
No	512	14.9	Sometimes	368	10.7
NA	15	0.4	Never	2867	83.3
			NA	20	0.6
Friends/Family house
DNA**			Always	2221	64.5
DNA**			Sometimes	1019	29.6
DNA**			Never	201	5.8
DNA**			NA	3	0.1
School
Yes	2471	71.7	DNA**
No	940	27.3	DNA**
NA*	33	1.0	DNA**
			DNA**
Health unit
Yes	2683	77.9	DNA**
No	752	21.9	DNA**
NA	9	0.3	DNA**
			DNA**
Police station
Yes	1522	44.2	DNA**
No	1755	51.0	DNA**
NA	167	4.8	DNA**

Housing features		Freq.	%
Type	House	3370	97.9
	Apartment	47	1.4
	Room	21	0.6
	Other/no answer	6	0.2
Ownership of residence	Owned and completely paid	2565	74.5
	Leased	501	14.6
	Transferred	331	9.6
	Financing	32	0.9
	Another condition/no answer	15	0.3
Type of construction	Masonry	2377	69.0
	Masonry without finishing	466	13.5
	Mud walls	401	11.7
	Mud walls without finishing	186	5.4
	Other/no answer	14	0.4
Sanitation		Freq.	%
Water supply	Public system with plumbing	2968	86.2
	Public system without plumbing	281	8.2
	Well water with plumbing	58	1.6
	Other sources/no answer	137	4.0
Waste sewage	Public system	1938	56.3
	Open air ditch	489	14.2
	Rudimentary cesspool os septic tank	381	19.8
	Other/No answer	336	9.7
Garbage collection	Collected daily	2427	70.4
	Thrown in vacant lot or river	624	18.1
	Secondhand Collected	382	11.1
Education		Freq.	%
Education of father	Did not study	434	16.8
	Incomplete or complete primary education	932	36.0
	Complete secondary education	642	24.8
	High school or higher	583	22.5
	Total	2591	100.0
Education of mother	Did not study	414	12.7
	Incomplete or complete primary education	1214	37.1
	Complete secondary education	936	28.6
	High school or higher	704	21.5
	Total	3268	100.0

	Frequency	%
Monthly income
No income	157	4.6
0.00 ---\| 0.25 MW	1216	35.3
0.25 ---\| 0.50 MW	1116	32.4
0.50 ---\| 1.00 MW	597	17.3
1.00 ---\| 2.00 MW	215	6.2
> 2.00 MW	71	2.1
No answer	72	2.1
Possession of consumer goods
Stove	3,410	99.0
Television	3,076	89.3
Refrigerator	2,298	66.7
Radio	2,020	58.7
Stereo	1,756	51.0
Washing machine	62	1.8
Environmental conditions
Lives in urbanized neighborhood	2456	71.3
Paved streets or sidewalks	2510	72.9
Streetlights	3367	97.8
Religion
Catholic	3047	88.5
Other	294	8.5
None	101	2.9

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[1] Corresponding author: Ana Cecília Silveira Lins Sucupira. Universidade de São Paulo, Hospital das Clínicas da FMUSP, Instituto da Criança. Avenida Enéas de Carvalho Aguiar. CEP 18760-000. Cerqueira Cesar, SP, Brasil. E-mail: asucupira@yahoo.com