Social inequalities in health in two metropolis of São Paulo State: measurement, monitoring and analysis

Abstract

Surveys have registered that the magnitude of the social inequalities in health, contrary to expectation, has remained stable or even has increased. The trend to reduction of income concentration observed between 1920 and 1970, reversed in 1980, so that in 2010 the degree of income concentration is similar to 1910/20. Also, contribute to the current relevance of the theme of social inequalities in health, the economic crisis that started in 2008, and has led several countries to a deep economic depression and to the adoption of policies of fiscal austerity witch tend to increase the health inequalities. Brazil is a country with one of the highest rates of concentration of income, which, added to the economic crisis and the austerity policies implemented, highlights the opportunity and current relevance of research on health social inequalities to qualify the knowledge about the patterns and trends of social disparities in health, in two of the most important cities of São Paulo, which are the focus of this thematic project.Considering the existence of periodic health surveys with wide thematic scope, developed in the cities of São Paulo and Campinas, originated from the multicenter Project ISA-SP (Process FAPESP No. 1998/14099-7) and the existence in these municipalities, since 1990, of programs directed to improve the quality of mortality information, the researchers of this thematic project aim, supported in special in those databases, to assess the magnitude of social disparities in multiple health dimensions and to monitor the changes of these inequalities over recent years.We consider that the conceptual framework adopted by the WHO Commission on Social Determinants in Health comprises the different dimensions of the determinants of the health-disease process and is adequate to support the studies proposed in this thematic project. Different compositions of social strata will be used to take account the effect of socio-economic, gender and ethnic. Previous development of indicators and techniques to measure the magnitude of social inequalities also provides a list of options that will be explored in the studies in order to identify the measures and techniques most appropriate depending on the design of the study, the proposed hypotheses and the health indicator in focus. (AU)