Condições de vida e mortalidade por doenças cardiovasculares na área de influência do Complexo Petroquímico do Estado do Rio de Janeiro - COMPERJ.

Abstract

The aim of this thesis was to identify and characterize areas with high rates of mortality from cardiovascular diseases and its two main subgroups of causes: ischemic heart disease (IHD) and cerebrovascular disease (CVD), between the years of 2008 and 2012 in the area of influence of the petrochemical complex in the state of Rio de Janeiro - COMPERJ, by means of statistical methods and geographic information systems (GIS). Research results presents in the form of two manuscripts. The first manuscript aimed to describe, characterize and predict areas of higher CHD death risk based on urban quality indicators classifications of spatial units. In order to obtain the predictive model for UVLs with different risks of CVD mortality, multivariate analysis, based on CART algorithm, was performed using the method known as regression and decision tree. The model was able to discriminate seven sets of UVLs with different average rates of mortality. The subset with the highest average range (1037/100 thousand inhab.) presents three UVLs over 75% of its household with inadequate water supply and IQU value above 0.6. It is concluded that there are areas under influence of COMPERJ's field where mortality from CHD presents greater magnitude. The identification of these areas can assist in preparation, prevention, diagnosis and planning of health actions aimed at groups that are more susceptible to CHD. The second manuscript investigated the profile of the spatial distribution of mortality from IHD and CVD in relation to the socioenviromental context according to geographical areas. The linear regression model with Poisson parameter via quasi-likelihood estimation was used to verify the association between variables. Greater income and the distance between households to health centers were identified as a variable relative to IHD and CVD mortality risk factors. The proportion of households on paved streets appears as a protective factor. The spatial distribution and associations found between outcomes and predictions suggest that populations residing in remote areas from urban centers have higher rates of mortality from IHD and CVD. This might be related to the location of the residencies due to the rural context and the population s geographical distance to health services. Thus, pointing there s a necessity of developing actions that provides greater amplitude to health services, aiming to reduce morbid cardiovascular incidents in those populations.