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Ramos JLS, Figueiredo FWDS, Zuchelo LTS, Purcino FAC, Adami F, Goncalves R, Ruiz CA, Baracat EC, Soares Junior JM, Sorpreso ICE. Health Services, Socioeconomic Indicators, and Primary Care Coverage in Mortality by Lower Genital Tract and Breast Neoplasias in Brazilian Women during Reproductive and Non-Reproductive Periods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5804. [PMID: 32796632 PMCID: PMC7460456 DOI: 10.3390/ijerph17165804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/03/2020] [Accepted: 08/08/2020] [Indexed: 06/11/2023]
Abstract
Women's health assistance at the low-complexity level is focused on the most common diseases and can be affected by primary health care coverage, particularly in areas far away from large urban centers. Thus, in this work, we aim to analyze the relationship between socioeconomic status, health care indicators, and primary care coverage in mortality from neoplasms of the lower genital tract and breast in Brazilian women during reproductive and non-reproductive periods. We conducted an ecological study at the Gynecology Discipline, Medicine School, University of São Paulo. Secondary data were collected from women according to reproductive periods and mortality data from the Mortality Information System based on International Classification of Disease-10th edition regarding breast and lower genital tract neoplasms in 2017. The health service and socioeconomic indicators were obtained from the Informatics Department of the Unified Health System and Brazilian Institute of Geography and Statistics. Our results showed that primary care coverage and health service indicators were not associated with mortality from breast cancer and the female lower genital tract, both in reproductive and non-reproductive periods. Sociodemographic indicators were found to be associated with mortality from breast cancer and the female lower genital tract, with income being associated with reproductive period (β = -0.4; 95% CI, -0.8 to -0.03) and educational level in the non-reproductive period (β = 9.7; 95% CI, 1.5 to 18.0).
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Affiliation(s)
- José Lucas Souza Ramos
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP 05403-000, Brazil; (J.L.S.R.); (L.T.S.Z.); (F.A.C.P.); (C.A.R.); (E.C.B.); (J.M.S.J.)
| | | | - Lea Tami Suzuki Zuchelo
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP 05403-000, Brazil; (J.L.S.R.); (L.T.S.Z.); (F.A.C.P.); (C.A.R.); (E.C.B.); (J.M.S.J.)
| | - Flávia Abranches Corsetti Purcino
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP 05403-000, Brazil; (J.L.S.R.); (L.T.S.Z.); (F.A.C.P.); (C.A.R.); (E.C.B.); (J.M.S.J.)
| | - Fernando Adami
- Epidemiology and Data Analysis Laboratory, Faculdade de Medicina do ABC (FMABC), Santo André, SP 09060-870, Brazil; (F.W.d.S.F.); (F.A.)
| | - Rodrigo Goncalves
- Setor de Mastologia, Disciplina de Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP 01246-000, Brazil;
| | - Carlos Alberto Ruiz
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP 05403-000, Brazil; (J.L.S.R.); (L.T.S.Z.); (F.A.C.P.); (C.A.R.); (E.C.B.); (J.M.S.J.)
| | - Edmund Chada Baracat
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP 05403-000, Brazil; (J.L.S.R.); (L.T.S.Z.); (F.A.C.P.); (C.A.R.); (E.C.B.); (J.M.S.J.)
| | - José Maria Soares Junior
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP 05403-000, Brazil; (J.L.S.R.); (L.T.S.Z.); (F.A.C.P.); (C.A.R.); (E.C.B.); (J.M.S.J.)
| | - Isabel Cristina Esposito Sorpreso
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP 05403-000, Brazil; (J.L.S.R.); (L.T.S.Z.); (F.A.C.P.); (C.A.R.); (E.C.B.); (J.M.S.J.)
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