Análise espacial da incapacidade funcional e vulnerabilidade social de idosos no Brasil: um estudo ecológico

Abstract

Introduction: The dynamics of aging brings with it an increased risk for the development of vulnerabilities of a biological, socioeconomic and psychosocial nature, given by the interaction between senescence and sociocultural processes. In this light, the conditions associated with the functional status and social vulnerability of elderly individuals stand out, determined from individual, collective, contextual and historical aspects of aging. Objectives: To evaluate the spatial distribution of indicators of functional disability and social vulnerability in Brazilian elderly in the years 2003, 2008 and 2013 and to verify the spatial dependence between indicators of functional disability in the year 2013. Method: Ecological observational study, with spatial analysis of the functional disability of the elderly and social vulnerability in the 26 Federation Units and the Federal District in the periods of 2003, 2008 and 2013. For the development of the study, four indicators related to the functional status of the elderly were collected, from the System of Health Indicators and Monitoring of Policies of the Elderly, in addition to the Social Vulnerability Index, provided by the Institute of Applied Economic Research. Data analysis was carried out in a descriptive way through the JASP 0.16.1 software, and by spatial analysis through the TerraView 4.2.2 and QGIS 2.18.3 software, with the presentation of the dependence by the Local Spatial Association Index (LISA). Results: Among the main findings, the leading role of the North and Northeast regions is evident as having the highest proportions of functional disability and social vulnerability. The analysis of spatial dependence between the variables of functional disability showed areas of High-High clusters concentrated mostly in the North, Northeast and Center-West regions, while Low-Low clusters prevailed in the Southeast, Center-West and North regions. Conclusion: Regional disparities were found for the spatial distribution of indicators, with a higher prevalence of functional disability in the Northeast and Midwest regions, in order to reflect a panorama of maintenance of historically established disparities and influenced by macrodeterminants, reiterating the need to instrumentalize and endorse the initiatives and strategic policies of care for the elderly, especially with regard to the maintenance of functional capacity during aging, based on the construct of a health system based on comprehensive care and intersectoriality of actions.