Principal investigator: Angelo Cruz do Nascimento Varella
Article title: SUSTAINABLE DEVELOPMENT AND CHILD HEALTH IN THE CURITIBA METROPOLITAN MESOREGION, STATE OF PARANÁ, BRAZIL
Article authors: Roberto Eduardo Bueno, Simone Tetu Moysés, Paula Alexandra Reis Bueno, Samuel Jorge Moysés, Max Luiz de Carvalho and Beatriz Helena Sottile França
Location of the Intervention: Metropolitan Region of Curitiba, Paraná, Brazil.
Sample Size: 37 municipalities
Main theme: Health Insurance
Type of Intervention: Analysis of data collected from the 2010 Brazilian Demographic Census.
Main Variable of Interest: Infant Mortality Rate for children up to 5 years of age
Evaluation Method: Cluster
Policy Problem
According to the United Nations, Sustainable Development consists of ecologically sound human activity, such that the relationship between society and the environment is mutually beneficial and lasting. Within this context, the economic viability of such activities is also considered, which depends on the proper use of available resources and social justice, which should prioritize vulnerable individuals and groups, aiming for equity.
Beyond economic aspects, Sustainable Development must also address the cultural parameters of a society, valuing the heterogeneity of different individuals and groups and offering opportunities for inclusive participation to all. This encompasses collective psychological health, stemming from individual and community autonomy and empowerment. These characteristics are important because they place the concept of public health within the context of Sustainable Development.
Therefore, it can be stated that the association between Sustainable Development and the promotion of public health is mainly determined by the implementation of sustainable solutions and the social inclusion of such processes. It is particularly relevant to consider inclusion in relation to combating poverty and its socioeconomic consequences, which are also obstacles to Sustainable Development.
Thus, the objective of this research is to measure the impact that the implementation of social indicators of Sustainable Development has on the public health of one of the most vulnerable segments of the population: children.
Evaluation Context
According to the National Commission on the Social Determinants of Health (CDSS – 2008), the fact that social inequality is one of the main causes leading to the massive loss of life in society is an injustice, since it is possible to work towards preventing it. This is because poverty is related to poor health conditions, which disproportionately affect the child population.
When evaluating the determinants of health in a society, it is possible to ascertain that children constitute a group particularly susceptible to the ills of poverty, especially in the first years of life, and that the consequences of poor public health conditions can permanently affect the adult population. Thus, studies indicate that public health policy programs seeking profound social impacts must have well-defined planning, in addition to requiring constant monitoring. In this way, it is possible to contribute to the living conditions of socioeconomically disadvantaged populations, ensuring the improvements resulting from the implemented programs. Within the scope of this research, the main aim is to support children and their families.
Intervention Details
Based on the premise that one of the fundamental principles of promoting public health is the development of actions geared towards the needs of the population, it is possible to affirm that the continuous planning and monitoring of public policies also constitute necessary conditions for framing these activities within the context of Sustainable Development. In other words, it is necessary to constantly evaluate the process, measuring the impact through robust and reliable indicators so that the premises of sustainability, viability, and equity are achieved.
In Brazil, data from the 2010 Demographic Census provide social indicators that reveal the social determinants of public health for municipalities. These parameters are used by researchers to investigate the relationship between observable Sustainable Development in the metropolitan region of Curitiba, Paraná, and outcomes in child public health, specifically regarding the mortality rate of children under five years of age.
Exclusive
The research consists of a cross-sectional ecological study that assesses how the health status of groups belonging to the metropolitan region of Curitiba is influenced by social, environmental, behavioral, and economic conditions. To this end, using data from the 2010 Demographic Census, the researchers utilized 16 contextual variables representing the dimensions of Sustainable Development in the context of the child population of 37 municipalities in the state of Paraná.
Based on the selection of this database, four categories of influence on social determinants were created, namely:
- Equity – is composed of seven indicators that assess the social characteristics of each municipality, in order to determine which regions have the best conditions for children's public health;
- Demographic Profile – quantifies the population and population density;
- Environmental Sustainability – consists of three indicators: preservation of native nature and distance from the urban center of the capital;
- Economic Sustainability – encompasses four economic indicators that directly impact children's health conditions.
Following this classification, the authors present the Sustainable Development Index, which is composed from the categories described previously. The authors then compare these results with data on infant mortality of children up to five years of age from the Ministry of Health database – DATASUS 2011.
Results
Based on an analysis of data from the 37 municipalities in the metropolitan region of Curitiba, the authors state that it is possible to relate the Sustainable Development Index to the reduction in the infant mortality rate, such that there is a moderate negative correlation between these parameters. The research also indicates that the Equity category also has a negative correlation with the mortality of children under five years of age.
In addition to this analysis, the authors classify the municipalities according to the results of the Sustainable Development Index for each locality, grouping them into sets according to the index. The distribution can be seen in the following image:
Figure 01 – Classification of municipalities according to the Sustainable Development Index
The first group (dark green) refers to municipalities with advanced Sustainable Development and corresponds only to the capital city of Curitiba. The second group (light green) consists of municipalities with a moderate index. The third group (pink) includes municipalities with an insufficient index, while the fourth group (red) represents localities with unsustainable development. The authors state that there is also a negative correlation between classification into the groups and infant mortality, such that municipalities with better Sustainable Development indicators have lower mortality rates for children under five years of age.
Lessons in Politics
Based on the study, it is possible to affirm that the pursuit of Sustainable Development is a promising path in combating socioeconomic inequality and preserving the environment, which consequently generates significant social benefits. Not only can poverty be reduced through economic progress, but it is also possible to achieve viable solutions that effectively reduce infant mortality rates, improving public health outcomes in the regions involved.
It is also worth noting that, in addition to implementing public policies aimed at Sustainable Development, it is also necessary to consolidate methods for monitoring and tracking these initiatives, in order to effectively ensure the conditions of economic viability, social equity, environmental sustainability, and the preservation of the customs and quality of life of individuals and groups.
Reference
BUENO, Roberto Eduardo et al. Sustainable development and child health in the Curitiba metropolitan mesoregion, State of Paraná, Brazil. Health & Place, v. 19, p. 167-173, 2013.
