Abstract
ABSTRACTOBJECTIVETo describe and assess currently used area-based measures of deprivation in Brazil for health research, to the purpose of informing the development of a future small area deprivation index.METHODSWe searched five electronic databases and seven websites of Brazilian research institutions and governmental agencies. Inclusion criteria were: studies proposing measures of deprivation for small areas (i.e., finer geography than country-level) in Brazil, published in English, Portuguese or Spanish. After data-extraction, results were tabulated according to the area level the deprivation measure was created for and to the dimensions of deprivation or poverty included in the measures. A narrative synthesis approach was used to summarize the measures available, highlighting their utility for public health research.RESULTSA total of 7,199 records were retrieved, 126 full-text articles were assessed after inclusion criteria and a final list of 30 articles was selected. No small-area deprivation measures that have been applied to the whole of Brazil were found. Existing measures were mainly used to study infectious and parasitic diseases. Few studies used the measures to assess inequalities in mortality and no studies used the deprivation measure to evaluate the impact of social programs.CONCLUSIONSNo up-to-date small area-based deprivation measure in Brazil covers the whole country. There is a need to develop such an index for Brazil to measure and monitor inequalities in health and mortality, particularly to assess progress in Brazil against the Sustainable Development Goal targets for different health outcomes, showing progress by socioeconomic groups.
Highlights
Brazil is a country with high rates of inequality, with the benefits of economic growth having been distributed inequitably[1,2]
No small-area deprivation measures that have been applied to the whole of Brazil were found
Few studies used the measures to assess inequalities in mortality and no studies used the deprivation measure to evaluate the impact of social programs
Summary
Brazil is a country with high rates of inequality, with the benefits of economic growth having been distributed inequitably[1,2]. Overall poverty rates have declined and global measures of socioeconomic conditions, such as the Human Development Index (HDI), have been showing consistent improvements in recent decades, internal disparities remain substantial. These disparities exist across both urban and rural contexts and have persisted during urbanization[3,4,5]. Given that socioeconomic status is one of the most consistent determinants of health[6,7], identifying those sub-populations that are still living in poverty, and being left behind despite economic growth, is an important task Such identification allows the monitoring of health inequalities, the understanding of their causes and facilitates the evaluation of the impact of social programs on health inequalities – all of which helps achieve health equity. Our aim is to establish the current state of scientific knowledge about measures of deprivation for the Brazilian population, through a scoping review of scientific databases and grey literature
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