Use of health services by the population living in contaminated areas in the region of the Santos and São Vicente estuarine system, Brazil

Abstract

ABSTRACT Objective: To relate the socio-demographic profile with access to health services of the population living in environmentally degraded areas in an estuary region. Study design: A sectional field study of 8819 people, evaluating three contaminated areas of São Vicente. Methods: Households were divided by studied area. A structured and pre-tested questionnaire was applied to obtain the data. A probabilistic sample was used. The prevalence of each of the outcomes of interest by area was calculated. To verify the existence of an association between the outcomes of interest and other variables (qualitative), by area, a descriptive analysis and to compare percentages and a comparison test was used between two proportions, a Chi-square test and/or a Fisher’s exact test and a Kruska-wallis and Dunn multiple comparison were used as well. The significance level was 5%. Results: Most residents (94%) reported the use of public health services at least once a year (p < 0.001), mainly through the Basic Health Units (BHU) (p < 0.001). Most of the studied population (65%) did not have private health insurance and their schooling was basically restricted to primary education (p < 0.001). The predominant family income (70%) in the three areas was between one and five minimum wages (p < 0.001), with a higher incidence of people receiving one to three minimum wages at the time. The demand for health services was not associated with education or income. Conclusion: The population of the regions analysed heavily rely on the Unified Health System – SUS, but there was no association between income and frequency of health services and there was also no association between education and use of health services.