Cardiovascular health and housing: An important dialogue held in precarious settlements in São Paulo

Abstract

The reduction of infectious diseases and longer life favored the greater prevalence of chronic diseases such as cancer, diabetes, cardiovascular and respiratory diseases. In general, the geographical scale of studies on socioeconomic conditions and health problems is the municipality. In this geographical scale there is no clear separation between the types of settlement. Intraurban studies by type of settlement can contribute to a more faithful portrait on inequalities in living conditions. In this study, data from residents of the municipality of São Paulo were analyzed who were admitted and those who died, by diseases of the circulatory system from 2010 to 2016 for deaths and from 2011 to 2016, for hospitalizations. Each hospitalization and death was attributed to the settlement of housing according to type: non-regular settlement, precarious or regular. The following calculations were made: proportion of hospital admissions by the Unified Health System (SUS) by groups of causes, standardized rates by gender and age group, hospitalization/inhabitant according to sex, age group and type of settlement and standardized rates by gender and age standardized mortality rates due to circulatory diseases. The results found an even more wicked situation in precarious settlements for all age groups, both sexes. The difference in cardiovascular health between the three types of settlements, evaluated through the proportions of hospital hospitalizations and mortality rates, show that almost 1,700,000 people in São Paulo are in a major disadvantage compared to the group formed by 85% of the population. In terms of hospitalizations, rates are higher in non-regular settlement. In this sense, it can be speculated that there is greater access to health service for residents of non-regular settlement in relation to those of precarious settlements. This access is reverted to lower mortality when the rates of both groups are compared. If we consider only two groups (regular and non-regular settlements), the situation of greater disadvantage in precarious settlements is diluted, becoming invisible. Such results can provide health surveillance to define specific programs for these settlements, as well as territory management, in general, to provide better housing conditions.