Análise dos determinantes sociais de saúde da população brasileira em condições pós-Covid-19

Abstract

The Social Determinants of Health (SDH) are social, economic, cultural, ethnic/racial, psychological, and behavioral factors that influence the occurrence of health problems. This study aimed to evaluate the SDH of the Brazilian population diagnosed with COVID-19 and to assess the existence of associations between the sociodemographic characteristics of the Brazilian population and the SDH. This is an ecological, descriptive, and quantitative study conducted across the five regions of Brazil, with a sample of 323 individuals who met the inclusion criteria: being Brazilian, aged over 18 years, and having been diagnosed with COVID 19. Data collection was carried out through a COVID-19 monitoring software, accessed via a link sent through messaging apps or email. The software includes an SDH questionnaire based on the Dahlgren and Whitehead model. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), employing absolute and relative frequencies, means, standard deviations, and likelihood ratio tests for proportion comparisons, considering p<0.05 as statistically significant. The study was approved by the Research Ethics Committee (Opinion No. 6.709.120; CAAE 77965124.2.0000.5054). The results showed a predominance of young individuals (18–39 years; 61.9%), female (73.4%), white (55.7%), and Catholic (44.9%). Alcohol and tobacco use were rarely reported by most participants. About one-third (33.4%) had completed higher education. Participants were from the Northeast (44.6%), Southeast (32.2%), South (9.3%), Central-West (8%), and North (5.9%) regions. The majority lived in inland areas (54.5%) compared to capital cities (45.5%). Post-COVID-19 conditions reported included autoimmune (3.7%), hepatic (2.8%), and respiratory diseases (6.5%). Hospitalization was required for 6.2% of participants, and 65.3% reported sequelae. Financial impacts were experienced by 31.2% of the respondents. Statistically significant associations were found between age and smoking (p=0.019), and consumption of processed foods (p=0.002); between sex and alcohol use (p=0.005); between religion and sleep difficulties (p=0.004); and between marital status and fruit/vegetable consumption (p=0.010), consumption of processed foods (p=0.008), and smoking (p=0.035). It is concluded that the findings highlight the impact of SDH on individuals’ lives post-COVID-19, showing that age, sex, marital status, and religion influence eating habits, tobacco use, and sleep quality. Married individuals demonstrated healthier habits, while divorced or widowed participants reported higher consumption of processed foods and tobacco. Understanding these factors may support the development of more effective public policies for post-COVID-19 recovery.