Os determinantes das condições de saúde dos idosos do município de São Paulo em uma perspectiva de ciclo de vida

Abstract

Throughout the twentieth century, the demographic dynamics established significant changes leading towards a fast population aging process ever seen in modern times. This process, on turn, has brought about socioeconomic consequences at both individual and collective level. Comprehension of the association between this process and health conditions is then crucial.First objective of this thesis is to propose an analytical framework in order to provide an overview of such association. The second objective is to examine the relationships between socioeconomic conditions over the life cycle of the elderly and three different dimensions of health measurement: chronic diseases, disability and health self-assessment. Data used are from the SABE project for the municipality of Sao Paulo and modeling was made using Poisson Regression and Ordered Logistic Regression.Results showed that cognitive impairment, high medicine consumption at middle age, smoking and lack of physical activity are the main determinants of adverse health conditions whatever the health measurement type used. Despite the communality, there are also specific determinants for each dimension of health that appear in all life cycles. Thus, policies towards reducing social and economic inequalities in childhood, adultness or at late age stages will have different impacts depending on the dimension used to measure health. For example, preventive attitudes such as immunization against infectious diseases during childhood -given the correlations found- could promote reduction in prevalence of chronic diseases and functional impairment at later ages. Similarly, investments in education and access to good health care services can assure a more positive self health assessment among the elderly.The conceptual frame proposed provides a kind of roadmap helpful for a better understanding of the mechanisms behind past and current socioeconomic and health conditions of the elderly people and the way they evolve throughout life. Also, this framework defines the set of information to be collected in order to built a better understanding of wellbeing and health determinants for the elderly population.