Abstract
This thematic issue consists of 14 articles derived from studies of the BRISA birth cohort (Ribeirão Preto, State of São Paulo and São Luís, State of Maranhão, northeastern Brazil, a socially and economically less developed region). In these more than 40 years of existence, these cohorts have been able to document the increase in women's education, the improvement of health conditions, the creation of a public Unified Health System (SUS) that provides universal and free access to health care, eradication of hunger, and transition of the nutritional status characterized by a decrease in malnutrition rates and an increase in obesity in Brazil. Particularly in reproductive health, the country experienced a significant drop in fertility, a decrease in maternal and child mortality, and an increase in breastfeeding rates. Universal access to prenatal care and hospital delivery was accompanied by an excessive number of cesareans without clinical indication and early-term births and premature births, largely due to scheduled cesareans. Articles with a longitudinal and transversal methodological approach are presented, using structural equation analysis and propensity score, together with multivariate regressions, which gave a robust analytical treatment to articles in this thematic issue.
Highlights
This thematic issue consists of 14 articles derived from birth cohort studies conducted in Ribeirão Preto (RP), State of São Paulo, southeastern Brazil, the most developed region in the country, and São Luís (SL), State of Maranhão, northeastern Brazil, the socially and economically least developed region
An interesting aspect of the cohorts is their composition involving two cities with different living conditions, which reflect the health conditions of the two places and which permit time-based assessment of the impact of federal public policies on these different social realities. During these more than 40 years of their existence, these cohorts have been able to document the major changes that occurred in the way of life and health standards of the Brazilian society: aging, increase in educational level especially among women, improvement of health conditions, creation of a public Unified Health System (SUS, in the Portuguese acronym) that provides universal and free access to healthcare, eradication of famine, and a nutrition transition characterized by a decrease in malnutrition rates and an increase in obesity
The articles that are part of this thematic issue address several of the items mentioned above and can be analyzed from different perspectives: studies comparing outcomes among individuals of the same cohort over time; studies comparing outcomes in the two cohorts; etiological studies and studies of risk factors for the health of pregnant women and their newborns; etiological studies of outcomes in children born in different cohorts; studies of health service utilization; and studies classified by type and method of analysis
Summary
This thematic issue consists of 14 articles derived from birth cohort studies conducted in Ribeirão Preto (RP), State of São Paulo, southeastern Brazil, the most developed region in the country, and São Luís (SL), State of Maranhão, northeastern Brazil, the socially and economically least developed region. In 2010, in an effort to further explore and expand aspects already addressed in the previous cohorts from the developmental origins of health and disease perspective, the RP and SL researchers simultaneously started a new birth cohort in both cities, called BRISA
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