Self-perceived health among ‘quilombolas’ in northern Minas Gerais, Brazil

Oliveira, Stéphany Ketllin Mendes; Pereira, Mayane Moura; Guimarães, André Luiz Sena; Caldeira, Antônio Prates

doi:10.1590/1413-81232015209.20342014

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Free Themes • Ciênc. saúde coletiva 20 (9) • Sept 2015 • https://doi.org/10.1590/1413-81232015209.20342014 copy

Self-perceived health among ‘quilombolas’ in northern Minas Gerais, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Over a century has passed since slavery was abolished in Brazil, yet quilombola communities remain socially vulnerable, especially when it comes to health. The goal of this study was to understand self-perceived health (SPH) in quilombola communities in Northern Minas Gerais, and the factors associated with their negative -perceived their own health. A household survey of a representative sample of quilombola communities in the study region. Validated tools were used to gather data about SPH, socioeconomic conditions, demographics, lifestyle and self-referred morbidity. Following a bivariate analysis, we proceeded to conduct a hierarchical logistics regression analysis. The prevalence of negative SPH was 46.0%. The following variables were statistically associated with negative SPH: age and years of schooling as distal variables, and high blood pressure, diabetes, arthritis, depression and back problems as proximal variables. SPH is associated with demographic and socioeconomic dimensions, and in particular with self-referred morbidity. The concept of health among the quilombola communities included in this study seems to be intimately linked to the absence of disease, especially chronic disease.

Key words
Health level; group with ancestors on the African content; epidemiological surveys; vulnerable communities; health (healthcare) inequality

Variables			(n)	(%)
Sociodemographic
	Gender
		Male	271	35.8
		Female	485	64.2
	Age (years)
		< 40	434	57.4
		40-59	268	35.4
		≥ 60	54	7.1
	Years of schooling (last grade completed)
		None	119	15.7
		1 – 4	336	44.4
		5 – 8	145	19.2
		≥ 9	156	20.6
	Marital Status
		Single	160	21.2
		Married/Stable Union	497	65.7
		Widowed	49	6.5
		Divorced/Separated	50	6.6
	Self-stated Skin Colour (Race)
		White (Caucasian)	11	1.5
		Black (Afro-descendant)	637	84.3
		Yellow (Oriental)	9	1.2
		Brown (Mullatto)	99	13.1
	Household Income (minimum salaries^* * Minimum Salary = R$ 678,00. )
		≤ 1	495	65.5
		2 – 3	239	31.6
		> 3	22	2.9
	Household Waste Destination
		Collected by Sanitation Service	27	3.6
		Collected in Dumpster	152	20.1
		Burnt	435	57.5
	Buried		28	3.7
		Discarded in empty lot/other	114	15.1
	Sanitary Waste
		Sewage Network	5	0.7
		Septic Tank	519	68.7
		Crude Septic Tank	119	15.7
		Ditch	52	6.9
		River. lake. other	61	8.1
	Electricity
		None	14	1.8
		Dedicated meter	656	86.8
		Shared meter	72	9.5
		No meter	14	1.9
	Water supply
		Town Water or equivalent	91	12.0
		Well or spring on property	164	21.7
		Well or spring not on property	304	40.2
	Tank truck		76	10.1
		Stored rainwater	32	4.2
		Rivers. dams. lakes. other	89	11.7
Life Habits
	Physical Activity
		Active	273	36.1
		Sedentary	483	63.9
	Tobacco use
		Smoker	182	24.1
		Non-smoker	574	75.9
	Alcohol use
		Drinks	239	31.6
		Does not drink	517	68.4

Variable			Self-perceived health				p-value	Gross OR
			Negative		Positive
			n	%	n	%
Sociodemographic							0.969	1.01 (0.75 – 1.36)
	Gender
		Male	125	35.9	146	35.8
		Female	223	64.1	262	64.2	0.000	1.84 (1.37 – 2.46)
	Age (years)
		≤ 40	176	50.6	146	35.8
		< 40	172	49.4	262	64.2	0.002	1.85 (1.24 – 2.75)
	Years of schooling
		Illiterate	70	20.1	49	12.0
		Literate	278	79.9	359	88.0	0.339	0.86 (0.64 – 1.17)
	Marital Status
		No partner	113	32.5	146	35.8
		Has partner	235	67.5	262	64.2	0.456	0.89 (0.66 – 1.20)
	Household Income^* * Minimum Salary = R$ 678,00.
		< 1 minimum salary	223	64.1	272	66.7
		≤ 1 minimum salary	125	35.9	136	33.3	0.811	1.04 (0.74 – 146)
	Household Waste
		Not Collected	267	76.7	310	76.0
		Collected	81	23.3	98	24.0	0.660	1.45 (0.97 – 2.17)
	Sanitary Waste
		Other	61	17.5	52	12.7
		Sewage Network/Septic Tank	287	82.5	356	87.3	0.995	0.99 (0.65 – 1.52)
	Electricity
		Other sources	46	15.4	54	13.24
		Dedicated meter	302	84.6	354	86.76	0.187	1.35 (0.86 – 2.11)
	Water supply
		Other sources	312	89.6	353	86.5
		Sewage Network	36	10.4	55	13.5
Life Habits							0.117	1.27 (0.94 – 1.71)
	Physical Activity
		Sedentary	136	39.1	137	29.2
		Active	212	60.9	272	70.8	0.115	1.31 (0.94 – 1.83)
	Tobacco use
		Smoker	93	26.7	89	21.8
		Non-smoker	255	73.3	319	78.2	0.345	0.862 (0.63 −1.17)
	Alcohol use
		Drinks	104	29.9	135	33.1
		Does not drink	244	70.1	273	66.9

Variable		Self-Perceived health				p-value	Gross OR
		Negative		Positive
		n	%	n	%
Hypertension						< 0.001	2.31 (1.68 – 3.16)
	Yes	141	40.5	93	27.8
	No	207	59.5	315	77.2
High Cholesterol						< 0.001	2.42 (1.48 – 3.96)
	Yes	51	14.6	27	6.6
	No	297	85.4	381	93.4
Cardiovascular Disease						0.001	3.35 (1.60 – 7.02)
	Yes	27	7.8	10	2.5
	No	321	92.2	398	97.5
Diabetes						< 0.001	3.61 (1.89 – 6.91)
	Yes	37	10.6	13	3.2
	No	311	89.4	395	96.8
Kidney Disease						0.001	2.58 (1.44 – 4.62)
	Yes	37	10.6	18	4.4
	No	311	89.4	390	95.6
Arthritis/Arthroses						0.001	3.21 (1.53 – 6.76)
	Yes	26	7.5	10	2.5
	No	322	92.5	398	97.5
Depression						< 0.001	3.01 (1.93 – 4.70)
	Yes	71	20.4	32	7.8
	No	277	79.6	376	92.2
Back Problems						< 0.001	2.27 (1.63 – 3.15)
	Yes	124	35.6	80	19.6
	No	224	64.4	398	80.4
Overweight/obese^* * Measured by the researchers. Based on BMI.						0.700	0.945 (0.71 −1.26)
	Yes	164	47.1	198	48.5
	No	184	52.9	210	51.5

Model			Gross Or (CI 95%)	Adjusted Or (CI 95%)	p-value
Distal Component*
	Age (years)				0.002
		< 40	1.00	1.00
		≥ 40	1.84(1.37– 2.46)	1.62(1.19– 2.19)
	Years of schooling				0.039
		Literate	1.00	1.00
		Illiterate	1.85(1.24-2.75)	1.55(1.02-2.38) x²(H-L): p-value: 0.566
Intermediate Component**
	Physical Activity				n.s.
		Active	1.00	n.s.
		Sedentary	1.04(0.78-1.39)
	Tobacco User				n.s.
		Non-smoker	1.00	n.s.
		Smoker	1.31(0.84-1.83)	x²(H-L): p-value: 0.842
Proximal Component***
	Hypertension				0.002
		No	1.00	1.00
		Yes	2.31(0.68-3.16)	1.74(1.23-2.48)
	High Cholesterol			n.s.	n.s.
		No	1.00
		Yes	2.42(1.48-3.96)
	Cardiovascular Disease			n.s.	n.s.
		No	1.00
		Yes	3.35(1.60-2.02)
	Diabetes				0.005
		No	1.00	1.00
		Yes	3.62(1.90-6.92)	2.66(1.35-5.26)
	Kidney Disease			n.s	n.s.
		No	1.00
		Yes	2.58(1.44-4.61)
	Arthritis/Arthroses				0.035
		No	1.00	1.00
		Yes	3.21(1.53-6.76)	2.32(1.06-5.07)
	Depression				<0.001
		No	1.00	1.00
		Yes	3.01(1.93-4.70)	2.78(1.75-4.42)
	Back Problems				<0.001
		No	1.00	1.00
		Yes	2.27(1.63-3.15)	1.88(1.33-2.66) x²(H-L): p-value: 0.667

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[1] Collaborations

SKM Oliveira helped design the project and with data collection, processing and analysis, and also helped draft the final text. MM Pereira helped with data collection, processing and analysis, and also helped draft the final text. ALS Guimarães participated in data analysis and helped draft the final text. AP Caldeira helped design the project, and also process and analyze the data, and draft the final text.