Prevalence of Self-Reported Chronic Diseases and Health Services Utilization by Ethnic Minorities in Manaus Metropolitan Region

Alencar, Raquel Rodrigues Ferreira Rocha de; Galvão, Taís Freire; Antonio, Bruno Vianei Real; Silva, Marcus Tolentino

doi:10.18865/ed.28.1.49

Cited by 9 publications

(9 citation statements)

References 20 publications

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“…Some of the diabetes prevalence studies included in our review focused on or mentioned participants from indigenous groups [35,48,50,74,83] and other underrepresented groups (e.g., Garifuna, Afro-Panamanian, Afro-Peruvian, Afro-Ecuadorian) [55,76,90,91,166]. However, a few studies have evaluated diabetes care, prevalence, and/or prevention of macro-or microvascular complications, diabetes management interventions, other health care needs and access to health care among indigenous populations [241,244,246,[294][295][296][297][298][299][300][301][302], and none on the other groups (that we could identify through our search). Understanding the protective mechanisms (e.g., biochemical, immune, epigenetic) against diabetes experienced by some indigenous populations would be relevant to millions at high risk of developing diabetes.…”

Section: Indigenous and Other Ethnic Underserved Populationsmentioning

confidence: 99%

Current State of Diabetes Mellitus Prevalence, Awareness, Treatment, and Control in Latin America: Challenges and Innovative Solutions to Improve Health Outcomes Across the Continent

et al. 2020

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Purpose of Review Latin America is the scenario of great inequalities where about 32 million human beings live with diabetes. Through this review, we aimed at describing the current state of the prevalence, awareness, treatment, and control of diabetes mellitus and completion of selected guidelines of care across Latin America and identify opportunities to advance research that promotes better health outcomes. Recent Findings The prevalence of diabetes mellitus has been consistently increasing across the region, with some variation: higher prevalence in Mexico, Haiti, and Puerto Rico and lower in Colombia, Ecuador, Dominican Republic, Peru, and Uruguay. Prevalence assessment methods vary, and potentially underestimating the real number of persons with diabetes. Diabetes unawareness varies widely, with up to 50% of persons with diabetes who do not know they may have the disease. Glycemic, blood pressure, and LDL-C control and completion of guidelines to prevent microvascular complications are not consistently assessed across studies, and the achievement of control goals is suboptimal. On the other hand, multiple interventions, point-of-care/rapid assessment tools, and alternative models of health care delivery have been proposed and tested throughout Latin America. Summary The prevalence of diabetes mellitus continues to rise across Latin America, and the number of those with the disease may be underestimated. However, some local governments are embedding more comprehensive diabetes assessments in their local national surveys. Clinicians and public health advocates in the region have proposed and initiated various multi-level interventions to address this enormous challenge in the region. Keywords Latin America. Diabetes prevalence. Diabetes treatment. Control. Diabetes complications. Interventions. Health care This article is part of the Topical Collection on Diabetes Epidemiology

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Section: Indigenous and Other Ethnic Underserved Populationsmentioning

confidence: 99%

Current State of Diabetes Mellitus Prevalence, Awareness, Treatment, and Control in Latin America: Challenges and Innovative Solutions to Improve Health Outcomes Across the Continent

et al. 2020

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“…This group presents reduced health insurance coverage and self-reported chronic diseases when compared with white individuals. 25 The elderly experienced lower underutilization of health services, which could be explained by a high prevalence of chronic diseases that require medical attention, as suggested by previous analyses. 24 Separated and widowed individuals were more likely to having never visited a doctor or a dentist.…”

Section: Discussionmentioning

confidence: 71%

“…People with brown skin, who constitute the biggest ethnic group in the region, experienced higher inequities in medical and dental consultation throughout their lifetime. This group presents reduced health insurance coverage and self‐reported chronic diseases when compared with white individuals …”

Section: Discussionmentioning

confidence: 99%

Inequity in utilizing health services in the Brazilian Amazon: A population‐based survey, 2015

Galvão

Tiguman

Caicedo-Roa

et al. 2019

Health Planning & Management

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Summary Background Although Brazil has a public and universal healthcare system, utilization of health services is marked by social and regional discrepancies. Objective To assess the prevalence and factors associated with underutilization of healthcare services in the Brazilian Amazon. Method Cross‐sectional, population‐based study. Adults aged over 18 years old were selected through probabilistic sampling. Underutilization of healthcare services was defined as never seeing a physician or a dentist. Poisson regression with robust variance was performed to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs). A complex sample design was considered. Results A total of 4001 individuals were included, of which 419 (10.4%; 95% CI, 9.5‐11.4%) never visited a physician or a dentist. In the adjusted analysis, underutilization was higher among poorer people (PR = 3.32; 95% CI, 2.16‐5.11), men (PR = 1.34; 95% CI, 1.10‐1.65), people with brown skin color (Brazilian mixed race; PR = 1.34; 95% CI, 1.02‐1.76), and people who are separated (PR = 1.40; 95% CI, 1.01‐1.94) and widowed (PR = 1.55; 95% CI, 1.02‐2.37), when compared with the reference categories. Individuals with informal jobs, those who are retired, students/housewives, and unemployed people were more vulnerable to underutilization than formal workers (P < .04). Conclusion Underutilization of healthcare services occurs in one‐tenth of adults in Manaus Metropolitan Region and is associated with social and economic inequities.

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“…Less frequent use of health services may explain the shorter waiting time found for ethnic minorities. 29 Previous analyses of this population have shown that people of brown skin color have less health insurance coverage and fewer self-reported chronic diseases -possibly due to lack of diagnosis -, whereas indigenous people have higher prevalence of chronic diseases. 29 Structural discrimination and racism my also explain the shorter consultation times found.…”

Section: Discussionmentioning

confidence: 90%

Tempo de espera e duração da consulta médica na região metropolitana de Manaus, Brasil: estudo transversal de base populacional, 2015*

Galvão¹,

Tiguman²,

Filho³

et al. 2020

Epidemiologia e Serviços de Saúde

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Objective. To assess waiting times and length of medical consultations in the Manaus metropolitan region, Brazil. Methods. This was a cross-sectional study conducted with adults living in the region in 2015. Waiting time for consultation and length of consultation in minutes were reported by the participants. Analysis was performed using Tobit regression and weighted by the sample design. Results. 4,001 individuals were interviewed. Average waiting time was 125.4 minutes (95%CI 120.2;130.5), while consultations lasted an average of 52.5 minutes (95%CI 48.0;57.0). Women, poor people, people with less education, indigenous people, people resident in the state interior, people without health insurance, and individuals seen by gynecologists waited longer for their consultation (p <0.05). Consultation time was shorter for non-White people, those with poor health status and those who had health insurance (p <0.05). Conclusion. On average length of medical consultations was half the waiting time. Social inequalities were observed in these lengths of time.

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Prevalence of Self-Reported Chronic Diseases and Health Services Utilization by Ethnic Minorities in Manaus Metropolitan Region

Abstract: Indigenous respondents had higher prevalence rates of the investigated diseases. Compared with Whites, Brown respondents had lower rates of self-reported arterial hypertension and diabetes, as well as lower rates of private health insurance coverage.

Cited by 9 publications

References 20 publications

Current State of Diabetes Mellitus Prevalence, Awareness, Treatment, and Control in Latin America: Challenges and Innovative Solutions to Improve Health Outcomes Across the Continent

Current State of Diabetes Mellitus Prevalence, Awareness, Treatment, and Control in Latin America: Challenges and Innovative Solutions to Improve Health Outcomes Across the Continent

Inequity in utilizing health services in the Brazilian Amazon: A population‐based survey, 2015

Tempo de espera e duração da consulta médica na região metropolitana de Manaus, Brasil: estudo transversal de base populacional, 2015*

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