Distribuição espacial e perfil epidemiológico das pessoas com deficiência em áreas cobertas pela estratégia saúde da família

Abstract

The spatial and epidemiological aspects involved in disability have not been meaningfully addressed yet in demographic and health research in Brazil. Research on the prevalence of the problems inherent in these people’s actual situation is fundamental because this permits knowledge on their health profile and living conditions. The general aim was to analyze the spatial distribution of disabled people in Crato-CE, while the specific aim was to identify disabled people, describe their epidemiological profile and the spatial distribution of these people to describe the events and location of excess risk areas. Cross-sectional study with a quantitative approach, elaborated between January 2010 and October 2011. In the first phase, Community Health Agents (CHA) received previous training through the application of the training plan for competency development in care delivery for disabled people, a methodological phase to support data collection. At that moment, instruments were used to assess the CHAs’ competences. In the second phase, the CHAs identified people with visual, hearing and physical impairments living in their coverage area through the registration forms. In the third phase, the disabled people’s homes were georeferenced. In the fourth phase, non-geographical data were submitted to statistical analysis in SPSS version 18. Chi-squared and chi-squared tests for paired data were applied to data on the CHAs’ profile and competency development. The profile of disabled people was described and the prevalence rates of socioeconomic variables were calculated. Graphical data were analyzed in Arcgis version 9.2., using Kernel’s intensity estimator. Thus, the goal was to verify the intensity of events in the areas concerned in order to identify excess risk areas. The research complied with Resolution 196/96, concerning research involving human beings. In the results, the disabled people’s profile was identified as men of productive age, living in rural areas, with low education and family income levels, coming from the city of Crato. In the spatial distribution, higher prevalence levels were evidenced in rural areas, with a larger number of residents in the Dom Quintino, Bela Vista, Campo Alegre, Ponta da Serra districts, as well as in urban areas with lower socioeconomic indicators. Health service coverage is satisfactory concerning the FHS, but rehabilitation, diagnostic support, test and specialized appointment scheduling and outpatient and hospital services are concentrated in the urban area. Thus, as supposed, the characteristics of the disabled people result in a profile that hampers the access to and accessibility of rehabilitation services, medical specialties and hospital services. Moreover, the profile suggests people with increased dependence on public services. Therefore, mobility strategies need to be created to enhance health service access. And, also: the CHAs are sensitive to this plea, but lack adequate measures to deliver health promotion care within the perspective of their mediating role.