Adolescer na zona rural da Bahia : condicionantes da saúde em comunidades quilombolas e não quilombolas

Abstract

The generation of adolescents in Brazil is large and a considerable number live in rural areas, marked by inequalities that make access to public health, education and leisure services difficult. These inequalities affect the different dimensions of adolescents' lives and reverberate, incisively in situations of morbidity and mortality, especially in the same rural area, with emphasis on quilombola and non-quilombola communities. The objective of this study was to characterize health conditioners of quilombola and non - quilombola adolescents from the rural zone of a city in Bahia's southwest. Cross-sectional study, carried out in 2015, with adolescents between 10 and 19 years old, living in quilombola communities (184) and non-quilombolas (210). A semi-structured questionnaire was used, adapted from national surveys. Differences were tested by Pearson's chi-square or Fisher's exact test. The concordances were verified by the weighted kappa. The prevalence ratio (PR) and its 95% confidence interval (95% CI) estimated the association by Poisson regression. A total of 390 adolescents were interviewed, 42.8% were quilombolas, 51.3% were female, and 52.3% were < 15 years old. The occurrence of sexual intercourse was associated with the median age of 15 years (PR = 1.42, 95% CI: 1.33-1.52) and to have experienced a dose of alcohol (PR = 2.41, 95% CI: 1.70-3.46). Bean consumption among the quilombolas was higher (RP = 1.11, 95% CI: 1.04-1.20) and vegetable consumption (RP = 0.73, 95% CI: 0.77-0.52) , Fruit (RP = 0.67, 95% CI: 0.48-0.92) and milk (RP = 0.68, 95% CI: 0.47-0.99) lower than non-quilombolas. The leisure-time sedentary lifestyle was associated with the female gender (PR = 1.36, 95% CI: 1.08-1.70), schooling aged 10 and over (PR = 1.70, 95% CI: 1.26 (OR = 1.51, 95% CI: 1.22-1.88), to the regular consumption of packet snacks (RP = 1.33, 95% CI: -2.28), to regular eating habits while watching TV 1.01-1.76) and to overweight (RP = 1.41, 95% CI: 1.11- 1.78). There was low agreement between body image categories and nutritional status (k = 0.32) and weight control attitudes (k = 0.44). The adolescents in the field demonstrated healthier eating habits, lower prevalence of sexual intercourse, leisure time inactivity, overweight / obesity, and practice of extreme attitudes detrimental to health compared to urban adolescents. However, precocity was observed at the beginning of sexual intercourse, associated with alcohol use, low fruit consumption, vegetables, milk and regular consumption of unhealthy food markers and imprecise perception of their weight and / or weight-related attitude. Economic inequality among the strata showed social inequalities present in the studied rural population. It is suggested that interventions that improve the quality of life, prevent the permanence of bad habits and minimize vulnerabilities. The effective intersectoriality between the fields of health and education within public policies is relevant, with a view to the insertion of themes that deal with healthy behaviors and habits to the maintenance of adolescents' health.