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Geografias da Diabetes Mellitus em Portugal: Como as Condições do Contexto Influenciam o Risco de Morrer

dc.contributor.authorSantana, Paula
dc.contributor.authorCosta, Cláudia
dc.contributor.authorLoureiro, Adriana
dc.contributor.authorRaposo, João
dc.contributor.authorBoavida, José Manuel
dc.date.accessioned2015-10-08T13:40:47Z
dc.date.available2015-10-08T13:40:47Z
dc.date.issued2014
dc.description.abstractIntroduction: Diabetes Mellitus is a public health problem that is on the increase throughout the world, including in Portugal. This paper aims to identify the changing geographic pattern of this cause of death in Portugal and its association with sociomaterial deprivation. Material and Methods: This is a transversal ecological study of the deaths by Diabetes Mellitus in Portuguese municipalities in three periods (1989-1993, 1999-2003 and 2006-2010). It uses a Bayesian hierarchical model in order to obtain a smooth standardized mortality ratio and the relative risk of death by Diabetes Mellitus associated to sociomaterial deprivation. Results: In 1989-1993, the highest smooth standardized mortality ratio values were found in coastal urban municipalities (80% of municipalities with smooth standardized mortality ratio ≥ 161, of which 60% are urban); in 2006-2010, the opposite was found, with the highest smooth standardized mortality ratio values occurring in rural areas in southern inland regions (76.9% of municipalities with smooth standardized mortality ratio ≥ 161, of which 69.2% are rural), particularly the Alentejo. The relative risk of death by Diabetes Mellitus increases with vulnerability associated to social and economic conditions in the area of residence, and is significant in the last two periods (relative risk: 1.00; IC95%: 0.98-1.02). Discussion: Diabetes Mellitus presents a geographic pattern marked by coastal-inland and urban-rural asymmetry. However, this has been altering over the last twenty years. 48% of the population reside in municipalities where the smooth standardized mortality ratio has increased in the last twenty years, particularly in the rural areas of inland Portugal. Conclusion: The highest smooth standardized mortality ratio are currently found in rural municipalities with the highest index of sociomaterial deprivation.pt_PT
dc.identifier.issn1646-0758
dc.identifier.urihttp://hdl.handle.net/10400.26/9880
dc.language.isoporpt_PT
dc.peerreviewedyespt_PT
dc.publisherOrdem dos Médicospt_PT
dc.relationGeography of health status - An application of a Population Health Index in the last 20 Years (GeoHealthS)
dc.relation.publisherversionhttp://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4019/3916pt_PT
dc.subjectDiabetes Mellituspt_PT
dc.subjectPortugalpt_PT
dc.subjectGeografia da Saúdept_PT
dc.subjectMortalidadept_PT
dc.titleGeografias da Diabetes Mellitus em Portugal: Como as Condições do Contexto Influenciam o Risco de Morrerpt_PT
dc.title.alternativeThe Geography of Diabetes Mellitus in Portugal: How Context Influence the Risk of Dyingpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleGeography of health status - An application of a Population Health Index in the last 20 Years (GeoHealthS)
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/5876-PPCDTI/PTDC%2FCS-GEO%2F122566%2F2010/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/COMPETE/PTDC%2FCS-GEO%2F122566%2F2010/PT
oaire.citation.conferencePlaceLisboapt_PT
oaire.citation.endPage317pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage309pt_PT
oaire.citation.titleActa Médica Portuguesapt_PT
oaire.citation.volume27pt_PT
oaire.fundingStream5876-PPCDTI
oaire.fundingStreamCOMPETE
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isProjectOfPublicationaba25d47-0953-4e01-89db-0aa93141e483
relation.isProjectOfPublication0e28f0b0-dc03-4aa8-8b57-6cf7e7e61602
relation.isProjectOfPublication.latestForDiscoveryaba25d47-0953-4e01-89db-0aa93141e483

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