Banca de DEFESA: ROBERTA SOUZA FREITAS
Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.DISCENTE : ROBERTA SOUZA FREITAS
DATA : 17/12/2020
HORA: 09:00
LOCAL: https://www.youtube.com/user/labvideoisc
TÍTULO:
Ideal cardiovascular health: an epidemiological analysis from an intersectional perspective in Elsa-Brasil.
PALAVRAS-CHAVES:
Intersectionality; Cardiovascular diseases; Social Discrimination; Social Segregation; Body Weight Trajectory; Cross-Sectional Studies; Mediation; Interaction.
PÁGINAS: 194
GRANDE ÁREA: Ciências da Saúde
ÁREA: Saúde Coletiva
RESUMO:
Cardiovascular diseases are the leading cause of death in Brazil and in all Brazilian regions, and most studies focus on morbidity aspects and risk factors. However, it is important to go beyond the illness of the population to reflect, analyze and understand how biological, socioeconomic and identity processes can promote cardiovascular health. Therefore, the American Heart Association (AHA) set a goal to reduce age-adjusted mortality rates and morbidity due to cardiovascular diseases and stroke, and they published an indicator called ideal cardiovascular health metrics. These metrics go beyond the definition of the absence of cardiovascular diseases and can be defined by identifying positive attributes of seven health factors or behaviors (diet, exercise, body mass index, smoking, blood pressure, fasting glycemia and cholesterol levels). Studies have identified low prevalence for these metrics and their association with several factors such as gender, socioeconomic status, race and age. Despite this, the focus on risk factors is insufficient since these associations do not seem to be unidirectional and they lead to health inequalities. An integrated approach using intersectional analyses is suggested to understand the complexity in which these inequalities affect each of these factors in different groups in the population. Thus, the general objective of this dissertation is to analyze cardiovascular health metrics using an intersectional perspective and data from adults participating in a Brazilian cohort. The used data comes from the baseline of the Longitudinal Study of Adult Health (ELSA-Brasil). The association between cardiovascular health metrics and intersectionality (with groups defined in terms of gender, race and schooling) was evaluated using analytical strategies that include additive and multiplicative interaction, and mediation analysis for the effect of intersectionality on cardiovascular health metrics via perception of discrimination and residential segregation. The association between anthropometric trajectory and cardiovascular health was also evaluated using an intersectional perspective. There was a trend towards higher mean values of cardiovascular health with the increase of the schooling level, with marked difference mainly among women. A statistically significant and positive interaction between sex and schooling was identified in the additive and multiplicative scales for the ideal cardiovascular health metrics. The importance of this relationship was confirmed by decomposing the effect of the inequalities in the metrics of ideal cardiovascular health in the presence of mediation (by perception of discrimination and residential segregation). The best levels of ideal cardiovascular health were observed among individuals who belong to high risk group of anthropometric trajectory only at birth (low or overweight at birth) and among those without risk (they did not present risk at birth and did not evolve to overweight in adulthood). Although cardiovascular health metrics are modifiable at the individual level, it is important to consider public policies aimed at reducing cardiovascular diseases, targeting primarily on increasing education for the population, and also at interventions to reduce residential segregation and to concentrate efforts to manage the current anthropometric status. Thus, assessing health using an intersectional perspective can assist in the improvement of the design and effectiveness of these policies.
MEMBROS DA BANCA:
Presidente - 2195844 - LEILA DENISE ALVES FERREIRA AMORIM
Interno - 2548659 - SHEILA MARIA ALVIM DE MATOS
Externo à Instituição - DANIELLE BIVANCO DE LIMA
Externo à Instituição - EMANUELLE FREITAS GOES
Externo à Instituição - ITAMAR DE SOUZA SANTOS
Externo à Instituição - MARIA DE JESUS MENDES DA FONSECA - ENSP