Autopercepção de saúde e qualidade de vida em adultos e idosos: associação com os determinantes sociais

Abstract

Self-perception in health, quality of life association with social determinants is an important topic to be taken in biomedical discourses and social scientists, for valuing the subjectivity of the subject; Is indicated by the World Health Organization as a method of assessing overall health in large surveys; Includes the biological, psychological and social dimensions of the person. Studies approach the theme in similarities as the guiding question and possibilities of answers; This research was driven by the following question: "How did you evaluate your health in the last 2 months?" And "How did you evaluate your quality of life in the last two months? Self-perception can be inferred as positive or negative and quality of life as good, fair, or poor. However, it is perceived that social opportunities and inequalities influence the lives of people and the ability to self-evaluate health and quality of life. These are called, in the discourses in health sciences, as social determinants of health (DSS), which broaden the concept of biological health, incorporating aspects of everyday life, culture and work; Which directly affect the maintenance of health status, vulnerability and / or illness. For SDH are the social, economic, cultural, ethnic / racial, psychological and behavioral factors that influence the occurrence of health problems and risk factors in the population; So we understand, that social inequalities can determine unequal lifestyles and behaviors in societies, which also culminates in different health patterns. GENERAL OBJECTIVE: To investigate the association between health selfperception and quality of life with social determinants in adults and the elderly. METHODOLOGY: This is a cross-sectional observational study with a probabilistic sample stratified by clusters, composed of 1129 participants, adults and elderly residents of Betim. The present research is a cut from the study SAUVI (Health and Violence: Grants for Formulation of Public Policies for Health Promotion and Prevention of Violence) developed by UFMG; Approved by the Ethics and Research Committee - CAAE number 02235212.20000.5149. All participants signed the informed consent form, being informed of the right of confidentiality and withdrawal of participation at any time in the research. The margin of error was of 1.9% for more or less, and degree of confidence 95%, other data were considered excluding. Data collection took the form of an interview at the participants' home and the following questions were selected as the guiding principles of the study: How did you evaluate your health in the last two months? How did you evaluate your quality of life in the last two months? Both questions had answers in Likert scale format with five points referenced as (1) Very bad, (2) Bad, (3) Fair, (4) Good, (5) Very good. In addition, participants answered questions regarding social determinants related to the following items: sex, age, schooling, religion, occupation / activity, marital status, color / race, family income, number of residents at home, health plan, medical consultations In the last 12 months, basic health unit / Health Post. The data were previously typed into a database and checked. The statistical analysis was based on the bivariate distribution of frequencies; To verify the association between self-perception of health and quality of life, a univariate analysis of the variables was performed, having as explanatory variables the questions related to the social determinants of health. In the final study, the variables with (p-value) 0.05 were considered statistically significant. We also performed an association between the exposure variables in studies and events, using the Pearson Chi-square test for homogeneity, besides this correspondence analysis (CA) was performed as a multivariate exploratory data analysis technique. Statistical Package for Social Sciences (SPSS) software version 21 and R (Development Core Team) version 3.30 were used for the final analysis of the data. RESULTS: Univariate analysis of this study evidenced positive self-perception of health and association with social determinants by (n811) participants; In relation to sociodemographic variables, the statistically significant data were p <0.05; There was a predominance of positive selfperception of health 66.6%, female 58.4%; Age range 30 to 39 years 26%; High school 37.8%; Occupation / formal and informal work 47.1% and 19.2% respectively; Family income between 2 and 5 minimum wages 37.7%. Regarding the socioassistential variables, the presence of health plan 52% and number of medical consultations between 1 and 2 a year 47.1% were evidenced; We can not find statistically significant results associated with socioeconomic variables: religion, marital status, color / race, number of people living in the same household, coverage of the number of people per private health plan and presence of a basic health unit ( UBS) close to home. Regarding the self-perception of the quality of life was approached as good in relation to sociodemographic variables, by (n-864) participants, equivalent to 76.5%, predominantly in women 58.6%; In the age group 30 to 39 years 25.7%, education with predominance of high school 36.8%; Presence of a partner in the condition of married and or stable union 47% and 13.2% respectively; Formal work 45.5%; Income in wages of 1 and 2 minimum wages, 37.7%; Presence of private health insurance, 45.6%; Coverage of the number of people by the private health plan 2 to 3 people 22%; And number of medical consultations in the last 12 months between 1 and 2 years had a good selfperception of the quality of life in 44%. In the study, the explanatory variables; religion; Color and race; Number of people living in the same household; The coverage of the number of people per private health plan and the presence of UBS / health center close to home did not have statistically significant data. CONCLUSION: The investigation of the association between self-perception of health and quality of life with social determinants in adults and the elderly revealed important results among the participants, it is emphasized that positive self-perception of health resulted in good quality of life, regular self-perception of health with Quality of life and similar negative self-perception of health with negative / poor quality of life, the influence of social determinants evidenced everyday conditions that are interrelated in a significant way with the selfperception and social determination of health and quality of life.