Áreas verdes e saúde coletiva: análise espacial da relação entre áreas verdes urbanas e taxas de internação por doenças respiratórias em Juiz de Fora - MG

Abstract

In Brazil, it is not common to use quantitative indicators in the development of urban public policies that aim at improving the environmental quality of cities. This research has the purpose of making a contribution in the area of Public Health, Epidemiology more specifically, to the field of Urbanism valuing a more quantitative and systematic way of assessing the benefits of Green Areas (AV) for urban populations. This study has the objective of verifying the hypothesis of a significant association between the existence of free public urban green areas and the occurrence of hospital admissions for respiratory diseases in Urban Regions of Juiz de Fora. We used the datas of hospitalization Unified Health System (SUS) of the years 2009, 2010 and 2011. From these was extracted the three-year average which was transformed into rates (per 100,000 inhab.) and which were applied to the direct method of standardization and weighting of data Empirical Bayesian Estimator Location. As the independent variable, we used the Index of Green Areas (IAV) categorized. The associations were controlled by demographic variables, age, sex, socioeconomic characteristics (Index of Social Development - IDS) and access to the units of Primary Health Care (UAPS) SUS. For this analysis, methods of spatial analysis in health were used. TerraView ® 4.2.0 software was used as Geographical Information System (GIS); Statistical tests for R and Epi InfoTM 3.5.2 software were used. Nonparametric Mann - Whitney test, Spearman's correlation analysis, Shapiro-Wilk test to test the normal distribution of data population. The results showed no significant association between admission rates and the presence of AV in Urban Regions (UR) in Juiz de Fora, and that such rates of morbidities are significantly associated with socioeconomic conditions of the UR through the IDS and the presence of UAPS RU in lower socioeconomic conditions. The results pointed to major social and economic disparities and the bad distribution of green areas in Juiz de Fora. It was noticed that social disparities have influence to an unequal distribution of health conditions in the urban space.