Background Research on discrimination and health focused on older adults has been scarce, comparatively with younger and middle-aged adults. Considering where people live matters, accurate measures of perceived discrimination might consider how the place of residence interferes on discriminatory experiences. This study aimed to assess the association between perceived discrimination and urban/rural place of residence among a representative sample of older adults in Brazil. Methods Data came from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), conducted in 2015/2016, with individuals aged 50 years and older. Perceived Discrimination was measured by means of the following question: “ In the past 12 months have you felt a victim of any type of discrimination ” with five possible answers: (1)“ when you sought medical services or health care ?”, (2)“ in social gatherings ?”, (3)“ in the work place? ”, (4)“ within the family? ”, (5)“ due to where you live? ”. Participants who answered yes for any of the five domains were coded as having reported an experience of discrimination. The main exposure variable was the urban-rural classification of the households, carried out according to the methods employed by the Brazilian Institute of Geography and Statistics during the 2010 Population Census. Other covariates included: age, sex, skin color, household wealth and education. Multiple Poisson regression was used to estimate prevalence ratios and their respective 95% confidence interval for the association between discrimination and independent variables. Results Prevalence of any perceived discrimination among Brazilian older adults was 16.8%. Regardless the place of residence (either urban or rural), participants reported health care settings as the most common domain where discriminatory experiences occurred and the work place as the least common. According to the adjusted model, perceived discrimination was significantly higher among urban dwellers when compared to their rural counterparts, independent of sociodemographic characteristics, health status and neighborhood social environment. The outcome was significant associated with skin color, education and health status. Conclusions Urban environment plays a core role in perceived discrimination and health care settings constitute the most common domain where discriminatory experiences occurred. Our findings may contribute to fulfill the knowledge gap on discrimination among older adults living in developing countries. Electronic supplementary material The online version of this article (10.1186/s12877-019-1076-4) contains supplementary material, which is available to authorized users.
Resumo O risco de hospitalização por asma influenciado pelo disparo das condições climáticas é pouco explorado em Minas Gerais. Os objetivos deste artigo são: a) avaliar a influência dos fatores climáticos nas hospitalizações por asma e por infecções virais do trato respiratório inferior (IVTRI), de 2002 a 2012, em crianças e adolescentes residentes em Belo Horizonte (BH) e estimar períodos epidêmicos para as hospitalizações por asma; b) comparar o padrão sazonal local das hospitalizações por asma e IVTRI. Utilizando as hospitalizações por asma estratificadas e por bronquiolite de 0-4 anos, a partir das guias de Internação Hospitalar, modelos estatísticos de regressão foram aplicados para avaliar o relacionamento entre as variáveis. Para estimar períodos epidêmicos foi utilizado o modelo de séries temporais da classe ARIMA. Foi observado um incremento nas hospitalizações por asma com aumento da umidade relativa no período pós-chuvas, as hospitalizações por bronquiolite se associaram a baixos níveis de temperatura máxima e precipitação. Períodos mais chuvosos podem propiciar o aumento da umidade outdoor e indoor favorecendo proliferação fúngica. Já os períodos mais frios podem favorecer o aumento da disseminação de vírus.
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