A relação de cursos dágua em leito natural em ambiente urbano commortalidade infantil e hospitalização por diarréia em crianças abaixo de cincoanos, em Belo Horizonte, Brasil

Abstract

To evaluate the possibility of hydrographic basin function as the unit of analysis in epidemiology, the examined literature identified the relation between this science with the environment and between the health promotion concept with the environmental crisis. It was pointed out the criticisms to the priority of present epidemiology to concentrate its studies to the individual level, banishing the social, ecological or even the molecular levels. It was presented new strategies to ecological or multilevel studies. Afterwards, the health promotion concept was approached as a possibility for internalization of environmental crisis in the community health, and also its application in large urban centers. It was concluded the hydrographic basin can work as the unity of analysis at the social and ecological levels, due to its precise limits; as well it is a quantifiable space, since it is adopted as the planning unity inlarge urban centers. Following to investigate the relation between infantile mortality and hospitalization due to childish diarrhea with water courses in natural streambed in Belo Horizonte, it was outlinedan exploratory ecological study taking the elementary river basins as unit of analysis. Contextual and composition variables regarding to five determinant groups were collected: streambed status, coverage of basic sanitation services, household, demography and socioeconomic situation. Mortality coefficients were defined from children born alive ordeceased, that inhabit Belo Horizonte in the period of 2000 to 2005. The coefficient used in the analysis was the median of the coefficients from 2000 to 2005. The hospitalization rates due to diarrhea in each elementary basin were calculated as the mean rates in the same period(2000-2005). In this study it is discussed the methodology and considerable results regarding to the influence of streams in natural riverbed, polluted with non-treated domestic sewage and other variables associated to infantile mortality and hospitalization due to diarrhea in children under fiver years old. After multiple regression analysis, the proportion of houses with constant sewage collection still remains associated to infantile mortality. The variables family gains, proportion of streams in natural riverbed and demographic density remained in the model to explain infantile diarrhea. It was concluded the hydrographic basin can work as the unity of analysis in epidemiology and the streams in natural riverbed polluted with sewage is associated with hospitalization rates due to diarrhea when the family gains is short and the demographic density is large.