Avaliação dos impactos do programa bolsa família na renda, na educação e no mercado de trabalho das famílias pobres do Brasil

This study aims to verify the impact of the Bolsa Família Program (BFP) in income and school attendance of poor Brazilian families. It is intended to also check the existence of a possible negative effect of the program on the labor market, titled as sloth effect. For such, microdata from the IBGE Census sample in 2010 were used. Seeking to purge possible selection biases, methodology of Quantilic Treatment Effect (QTE) was applied, in particular the estimator proposed by Firpo (2007), which assumes an exogenous and non-conditional treatment. Moreover, Foster- Greer-Thorbecke (FGT) index was calculated to check if there are fewer households below the poverty line, as well as if the inequality among the poor decreases. Human Opportunity Index (HOI) was also calculated to measure the access of young people / children education. Results showed that BFP has positively influenced the family per capita income and education (number of children aged 5-17 years old attending school). As for the labor market (worked hours and labor income), the program showed a negative effect. Thus, when compared with not benefiting families, those families who receive the BFP have: a) a higher family income (due to the shock of the transfer budget money) b) more children attending school (due to the conditionality imposed by the program); c) less worked hours (due to sloth effect in certain family groups) and d) a lower income from work. All these effects were potentiated separating the sample in the five Brazilian regions, being observed that the BFP strongly influenced the Northeast, showing a greater decrease in income inequality and poverty, and at the same time, achieved a greater negative impact on the labor market

Mudanças no rural nordestino: uma análise dos determinantes da pluriatividade nas famílias rurais nordestinas, no ano de 2011

This study aims to the evaluate the determinants for rural households northeastern be pluriactive, in 2011. For this, at first, we conducted a review of national and international literature in order to get beyond the theoretical part which refers to the study of pluriactivity identify possible determinants of the phenomenon. In this rescue, it was the observed determinants could be macroeconomic in nature and / or microeconomics. Therefore, it became necessary to describe the characteristics of the region under study, the Northeast. In order to identify the determinants were two estimated Probit models, one based on the literature review and the second with a variable characteristic of the Northeast, the transfers. For this, we used the PNAD in 2011. The results indicate both the microeconomic determinants are : gender, race, age, years of education, hours worked, number of family members, per capita income, transfer the macroeconomic in nature: living conditions (water, energy, sanitation ), housing location. In addition to identifying the determinants, the Econometric model allows to know the probability of each variable on the dependent variable, which stood out: the transfer variable, gender, per capita income, number of family members, housing conditions and housing location. Therefore, it is concluded that it is the set of determinants (macro and micro) allow rural families become northeastern pluriactive. However, one can not fail to consider may also have other determinants were not captured due to the availability of data, which may be indications for future studies. In summary, the pluriactivity in the Brazilian Northeast is a phenomenon distinct from found in Europe and southern Brazil. It is a pluriactivity survival that is part of the strategies of rural households in the Northeast to ensure their social reproduction amid the poverty of the region

A incorporação da saúde bucal no programa saúde da família do Rio Grande do Norte: investigando a possibilidade de conversão do modelo assistencial

The Health Family Program (HFP) was founded in the 1990s with the objective of changing the health care model through a restructuring of primary care. Oral health was officially incorporated into HFP mainly through the efforts of dental professionals, and was seen as a way to break from oral health care models based on curative, technical biological and inequity methods. Despite the fast expansion of HFP oral health teams, it is essential to ask if changes are really occurring in the oral health model of municipalities. Therefore, the purpose of this study is to evaluate the incorporation of oral health teams into the Health Family Program by analyzing the factors that may interfere positively or negatively in the implementation of this strategy and consequently in the process of changing oral health care models in the National Health System in the state of Rio Grande do Norte, Brazil. This evaluation involves three dimensions: access, work organization and strategies of planning. For this purpose,19 municipalities, geographically distributed according to Regional Public Health Units (RPHU), were randomly selected. The data collection instruments used were: structured interview of supervisors and dentists, structured observation, documental research and data from national health data banks. It was possible to identify critical points that may be impeding the implementation of oral health into HFP, such as, low incomes, no legal employment contract, difficulty in referring patients for high-complexity procedures, in developing intersectoral actions and program strategies such as epidemiologic diagnosis and evaluation of the new actions. The majority of municipalities showed little or no improvement in oral health care after incorporating the new model into HFP. All of them had failures in most of the aspects mentioned above. Furthermore, these municipalities are similar in other areas, such as low educational levels in children from 7 to 14 years of age, high child mortality rates and wide social inequalities. On the other hand, the five municipalities that had improved oral health, according to the categories analyzed, offered better living conditions to the population, with higher life expectancy, low infant mortality rates, per capita income among the highest in the state as well as high Human Development Index (HDI) means. Therefore, it is possible to conclude that public policies that include aspects beyond the health sector are decisive for a real change in health care models

Desigualdade regional da mortalidade neonatal no Brasil

In Brazil, despite the decline in infant mortality in recent decades it still has high rates going against recommended by WHO. Being the largest percentage of infant mortality rate composed of neonatal deaths. Objective: A study was conducted to analyze the spatial distribution of neonatal mortality and its correlation with the biological, socioeconomic and maternal and child health care in the Brazilian states in the period from 2006 to 2010. Method: The study made thematic maps and correlation (LISA) for verification of spatial dependence and multiple linear regression models. Results: Was found that there is no spatial autocorrelation for neonatal mortality in the Brazilian states (R = 0.002, p = 0.48). Most of variables were correlated (r> 0.3, p <0.05) with neonatal mortality, forming clusters in the North and Northeast, with the highest rates of teenage mothers, low household income per capita, lower prenatal appointments and beds of Neonatal Intensive Care Unit. The number of Neonatal UCI beds remained independent effect after regression analysis. Conclusion: The study concludes that regional inequalities in living conditions and especially the access to maternal and child health services contribute to the unequal distribution of neonatal mortality in Brazil

A relação entre os determinantes sociais em saúde e os investimentos setoriais e a mortalidade infantil em municípios brasileiros com mais de 80 mil habitantes

Investments in health have controversial influence on results of the health of populations, besides being subject rarely explored in literature. Moreover, from the 1970s, the social determinants of health have been consolidated in the disease process as multifactorial factors (social, economic, cultural, etc.) that directly or indirectly influence the occurrence of health problems of populations, as well as mortality rates. This study aimed to evaluate the influence of these investments and the social determinants of health on infant mortality and its neonatal and post-neonatal mortality. This is an ecological study, in which the sample was composed of Brazilians cities with over 80,000 inhabitants, avoiding fluctuations in mortality rates for common small populations, and ensure greater coverage of information systems on mortality and births Brazilians and, therefore, increase data consistency. To isolate the effect of investments in health, we used multiple linear regression. The socioeconomic indicators (p <0.001, p = 0.004, p <0.001), the inequality index (p <0.001, p = 0.001, p = 0.006) and coverage of prenatal visits (p <0.001, p <0.001; p = 0.005) were associated with infant mortality rate total, neonatal and post-neonatal, and the Gross Domestic Product per capita only influenced the overall infant mortality rate and neonatal (p=0.022; 0.045). Investments in health, in this model, lost statistical significance, showing no correlation with mortality rates among children under one year. We conclude that the social determinants of health has an influence on the variation in mortality rates of Brazilian cities, however the same was not observed for indicators of health investment

Famílias privadas de liberdade: a saga da violência vivenciada por adolescentes que trilham os áridos caminhos da criminalidade

This paper has as its main focus the relation between the infringement act and the adolescents families social economical problematic, who obey the social educational deprivation of freedom at CEDUC in the district of Pitimbu RN, establishing in the theme Children and Adolescents, with the objective of showing how these families breed in the social economical and cultural political aspect. It also seizes who those adolescents are and their family members in their social aspect and as those families face their daily activities. The focus on the social matter, family, adolescent, infringement act, exclusion, inclusion formed the analysis categories which made myths and reality possible, taking into consideration the infringement act in our society. The data collection showed that those families conditions of life are of poverty. Families originated from low social classes, 62.5 % coming from the countryside and living with a daily income ranging from R$ 0,31 to R$ 8,31. Their level of education is low; there is lack of human and citizenship rights and no professional qualification whatsoever. It questions the degrading social exclusion suffered by millions of Brazilian people due to social, political and infringement economical problems. Has this favored the infringement practice? How to confirm the families lack of competence having the social vulnerability? Are the Public Political Institutions really performing the way they should? Are they really carrying out their role as they should? We have noticed that from then on, the necessity of understanding the exclusion/inclusion suffered not only in an imprecise and empty way, but understood as processes of integrative exclusion or ways of delinquency, where the excluding is not only the only one who has lack of material care but the one who is seen or recognized as a person, is not being treated as one. The effort of this paper provided an approach to our object, and the seizing of a close relation between the infringement act and the exclusion process or inclusion suffered, which are submitted to families of those adolescents who deprive of freedom

O Processo de revisão do benefício de prestação continuada-BPC: uma lógica de exclusão ou inclusão social

This research comprises a study about the social assessment performed by the Social Worker in the review process of the Benefit of Continued Installment. The Benefit of Continued Installment was implemented in 1996 and guarantees a minimum salary to the deficiency person and to an elder with sixty five years or more and that proves not to have ways to support neither himself/herself nor his/her own family. It is a demand to include in the BPC that the maximum income of a family does not exceed ¼ of minimum salary and that every two years this benefit to be revised to evaluate its continuity based in its original conditions. This study was carried out in the municipality of Natal/RN, with thirteen social workers, being the collection of data performed through interviews and social assessments of the users that count with the benefit. The results show that the users selected by the criterion of the income, present a profile of poverty and deprivations demonstrated through several situations survived in its daily life, indicative of vulnerability. It was demonstrated that the Social workers has relative autonomy in the evaluations along with the users and that it denotes the necessity of inclusion. However, by following the imposed criteria, it corroborates with the logic of exclusion. So, it is identified in the Municipality of Natal/RN, following the orientation given the politics of social work at national level, the implementation of revision of the BPC, for the social workers, from rigorous processes of selection and exclusions

O Benefício da Prestação Continuada BCP: as condições de vida dos usuários no Município de Macau/RN

This rescearch comprises a study of the life condictions of the users of the Continuous Installment Allowance in the city of Macau, RN. This benefit has been predicted by the Federal 1988 Constitution and regulated by the Social Assistance Organic Law (LOAS), but it has been carried out only since january 1996. It consists of an amount of half a minimum salary given to old-age and handicapped peoplewhose families mathch the per capita income criterion of less than 0,25 minimum salary. It is a least-income policy relud by the principle of the smallest elegibility. The study focused on aged or handicapped people who were receiving the BPC from 1996 to 2004. Through a quatitative analysis, the life reality of these users has been critically examined. In order to achieve this, it has been necessary to trace their social and economical profile. The research revealed the precarious life conditions of the aged and handicapeed people after they were given the BPC, as well as their interpretation of this politcal directive, and also the need for revision of the eligibility criteria so that a public policy of integral service to the basic needs of the social being can be accomplished

Impactos sócio-econômicos e ambientais da introdução da Tilápia do Nilo, Oreochromis niloticus, em açudes públicos do semi-árido nordestino, Brasi

The stocking of exotic fish, especially the tilapia, has become a common practice in the public reservoirs of the Brazilian semi-arid region. The stocking of tilapias has had as its main aim the improvement of the fisheries in the reservoirs and consequently the improvement of the socio-economic conditions of the families that have fishing as the main source of income. However, the environmental risks associated with this practice are high and can lead to a loss in aquatic biodiversity and to changes in the quality of the water. The object of this work was to quantify the socio-economic and environmental effects of the introduction of the Nile tilapia in the public reservoirs of the semi-arid northeastern Brazil. The analysis of the fish yield of 100 public reservoirs from 1970 to 2000 demonstrated that the introduction of the Nile tilapia apparently contributed to an increase in the total fish yield from the late 1970 s until the mid-1980 s. Nevertheless, from that time onwards the fish yield in these reservoirs has fallen into decline to levels inferior to those observed prior to the introduction of the tilápia. The analysis of the fishing activity statistics of the Gargalheiras reservoir located in the city of Acari, Rio Grande do Norte, demonstrated that the introduction of the Nile tilapia in the reservoir has not significantly increased the fish yield, the gross overall income, the gross per capita income nor the number of fishermen actively fishing in the reservoir. On the other hand, the analysis of the fishing activity statistics of the Gargalheiras reservoir has revealed a significant reduction in the captures of other commercially important fish species after the introduction of the tilapia. This result suggests that the Nile tilapia could have negatively affected other species of fish in the reservoir, contributing to the decline in their stocks. In order to assess the perception of the fishermen concerning the effects of the Nile tilapia over other species of fish and the quality of the water, questionnaires containing open and multiple choice questions were applied with 30 fishermen from the colony of the Gargalheiras reservoir. The great majority of the local fishermen stated that the tilapia is currently the most important species of fish to those who depend on fishing as a source of income and that they have not caused damage to other species of fish nor to the quality of the water in the reservoir. However, the results of the present work indicate that the alleged socio-economic benefits, employed to justify the introduction of the Nile tilapia in the reservoirs, are overestimated while the environmental impacts of the introduction of this exotic species are underestimated

Social support and infant malnutrition: a case-control study in an urban area of Southeastern Brazil

The relationship between malnutrition and social support was first suggested in the mid-1990s. Despite its plausibility, no empirical studies aimed at obtaining evidence of this association could be located. The goal of the present study was to investigate such evidence. A case-control study was carried out including 101 malnourished children (weight-for-age National Center for Health Statistics/WHO 5th percentile) aged 12-23 months, who were compared with 200 well-nourished children with regard to exposure to a series of factors related to their social support system. Univariate and multiple logistic regressions were carried out, odds ratios being adjusted for per capita family income, mother's schooling, and number of children. The presence of an interaction between income and social support variables was also tested. Absence of a partner living with the mother increased risk of malnutrition (odds ratio 2.4 (95 % CI 1.19, 4.89)), even after adjustment for per capita family income, mother's schooling, and number of children. The lack of economic support during adverse situations accounted for a very high risk of malnutrition (odds ratio 10.1 (95 % CI 3.48, 29.13)) among low-income children, but had no effect on children of higher-income families. Results indicate that receiving economic support is an efficient risk modulator for malnutrition among low-income children. In addition, it was shown that the absence of a partner living with the mother is an important risk factor for malnutrition, with an effect independent from per capita family income, mother's schooling, and number of children.

Socioeconomic and demographic profile of leprosy carriers attended in nursing consultations

A hanseníase é doença infecto-contagiosa para a qual, além das condições individuais, outros fatores relacionados aos níveis de endemia e às condições socioeconômicas desfavoráveis influem no risco de adoecer. Objetivou-se reconhecer o perfil socioeconômico e demográfico e o grau de incapacidade instalado dos portadores de hanseníase, atendidos no Centro de Saúde Escola de Botucatu, São Paulo, Brasil. Fizeram parte do estudo 37 pacientes. Os dados foram obtidos por meio do instrumento de consulta de enfermagem. Os resultados mostraram predominância de indivíduos com união estável (78%), brancos (92%), com idade entre 30 e 49 anos (51%), com baixo nível de escolaridade e com renda familiar per capita menor que um salário mínimo. Mais de um terço dos pacientes investigados (35%) apresentavam algum grau de incapacidade física. A associação do baixo perfil socioeconômico com a presença de incapacidades físicas imprime maior vulnerabilidade a essa população, podendo impactar negativamente a sua qualidade de vida.

Transtornos mentais comuns e uso de psicofármacos: impacto das condições socioeconômicas

OBJETIVO: Avaliar a influência das condições socioeconômicas na associação entre transtornos mentais comuns, uso de serviços de saúde e de psicofármacos. MÉTODOS: Estudo transversal populacional conduzido na cidade de Botucatu, SP, com amostragem probabilística, estratificada e por conglomerados. Foram realizadas entrevistas domiciliares com 1.023 sujeitos de 15 anos ou mais de idade, entre 2001 e 2002. Transtorno mental comum foi avaliado utilizando o Self Reporting Questionnaire (SRQ-20). O uso de serviços foi investigado com relação à quinzena anterior à entrevista e uso de psicotrópicos, nos três dias anteriores. Utilizou-se regressão logística para análise multivariável, considerando o efeito do desenho. RESULTADOS: No total da amostra, 13,4% (IC 95%: 10,7;16,0) procuraram serviços de saúde na quinzena anterior à entrevista. A procura de serviços de saúde se associou ao sexo feminino (OR=2,0) e à presença de transtorno mental comum (OR=2,2). Na amostra 13,3% (IC 95%: 9,2;17,5) referiram ter usado ao menos um psicotrópico, destacando-se os antidepressivos (5,0%) e os benzodiazepínicos (3,1%). Na análise multivariável, sexo feminino e presença de transtorno mental comum mantiveram-se associados ao uso de benzodiazepínicos. Renda per capita mostrou-se direta e independentemente associada ao uso de psicofármacos, conforme aumento da renda. CONCLUSÕES: Menor renda associou-se à presença de transtorno mental comum, mas não ao uso de psicotrópicos. A associação entre transtorno mental comum e uso de psicotrópicos e maior renda reforça a hipótese da existência de iniqüidades no acesso à assistência médica na população estudada.

Fatores associados à vacinação contra influenza em idosos em município do Sudeste do Brasil

OBJETIVO: Mesmo gratuita e disponível no Brasil desde 1999, a cobertura vacinal contra a influenza ainda é inadequada em diversos municípios do País. O objetivo da pesquisa foi estimar a cobertura vacinal e identificar fatores relacionados à vacinação contra a influenza em idosos. MÉTODOS: Realizou-se inquérito domiciliar em amostra aleatória sistemática (N=365) da população urbana maior de 60 anos em Botucatu, São Paulo. Foi aplicado modelo de regressão logística múltipla, cuja variável dependente foi ter sido vacinado em 2002. Foram testadas no modelo as covariáveis: sexo, idade, socioeconômicas (renda per capita, número de pessoas por cômodo, escolaridade, estado civil, ocupação, tempo de moradia), antecedentes mórbidos, de internação, hábito de fumar, sintomas respiratórios nos últimos 15 dias e atividades comunitárias (trabalho voluntário, atividades no bairro, igreja). RESULTADOS: Registrou-se cobertura vacinal de 63,2% (IC 95%: 58,3-68,2). Foi observado menor percentual de vacinados entre os idosos na faixa etária de 60 a 64 anos. As variáveis que se mostraram associadas à vacinação e permaneceram no modelo final foram: idade (OR=1,09 por ano; IC 95%: 1,06-1,13); hipertensão arterial (OR=1,92; IC 95%: 1,18-3,13); inserção em atividades na comunidade (OR=1,63; IC 95%: 1,01-2,65). A vacinação em portadores de doenças crônicas não atingiu níveis adequados conforme esperado para este grupo de risco, com exceção dos hipertensos. A participação em atividades comunitárias e sociais foi relacionada com o estado vacinal. CONCLUSÕES: Condições socioeconômicas, hábitos e idade não restringiram o acesso à campanha vacinal. Por outro lado, campanhas específicas, endereçadas a indivíduos da faixa de 60 a 64 anos, podem ampliar a cobertura da vacinação.

Malnutrition in the second year of life and psychosocial care: a case-control study in an urban area of Southeast Brazil

O objetivo do estudo foi identificar e medir a presença de associação entre cuidado psicossocial e desnutrição. Realizou-se estudo caso-controle incluindo 101 crianças desnutridas (peso/idade < percentil 5 do padrão NCHS/OMS), com idades entre 12 e 23 meses, que foram comparadas a 200 controles eutróficos (peso/ idade > percentil 25) em termos de sua exposição a uma série de comportamentos maternos indicadores da qualidade de seu cuidado psicossocial. Criou-se um escore de cuidado psicossocial, variando de 0 a 14, de acordo com o número de comportamentos maternos desejáveis não observados: quanto maior o escore, pior a qualidade do cuidado psicossocial. Mediante análise de regressão logística verificou-se maior risco de desnutrição para as crianças no 2º e 3º tercis do escore de cuidado psicossocial. Esta associação foi modificada pela renda per capita. Após ajustes para possíveis confundidores, nas crianças dos estratos superiores de renda não houve associação entre cuidado psicossocial e desnutrição. Para as crianças com nível mais baixo de renda, pior cuidado psicossocial dobrou o risco de desnutrição (OR = 7,26; IC95%: 2,42-21,82) em relação àquele associado apenas à baixa renda (OR = 3,08; IC95%: 1,28-7,42).

Fatores associados a não realização da mamografia e do exame clínico das mamas: um estudo de base populacional em Campinas, São Paulo, Brasil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)