Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

The Impact of Socioeconomic Factors, Coverage and Access to Health on Heart Ischemic Disease Mortality in a Brazilian Southern State: A Geospatial Analysis.

Publication ,  Journal Article
de Carvalho Dutra, A; Silva, LL; Pedroso, RB; Tchuisseu, YP; da Silva, MT; Bergamini, M; Scheidt, JFHC; Iora, PH; do Lago Franco, R; Staton, CA ...
Published in: Glob Heart
January 20, 2021

BACKGROUND: No other disease has killed more than ischemic heart disease (IHD) for the past few years globally. Despite the advances in cardiology, the response time for starting treatment still leads patients to death because of the lack of healthcare coverage and access to referral centers. OBJECTIVES: To analyze the spatial disparities related to IHD mortality in the Parana state, Brazil. METHODS: An ecological study using secondary data from Brazilian Health Informatics Department between 2013-2017 was performed to verify the IHD mortality. An spatial analysis was performed using the Global Moran and Local Indicators of Spatial Association (LISA) to verify the spatial dependency of IHD mortality. Lastly, multivariate spatial regression models were also developed using Ordinary Least Squares and Geographically Weighted Regression (GWR) to identify socioeconomic indicators (aging, income, and illiteracy rates), exam coverage (catheterization, angioplasty, and revascularization rates), and access to health (access index to cardiologists and chemical reperfusion centers) significantly correlated with IHD mortality. The chosen model was based on p < 0.05, highest adjusted R2 and lowest Akaike Information Criterion. RESULTS: A total of 22,920 individuals died from IHD between 2013-2017. The spatial analysis confirmed a positive spatial autocorrelation global between IDH mortality rates (Moran's I: 0.633, p < 0.01). The LISA analysis identified six high-high pattern clusters composed by 66 municipalities (16.5%). GWR presented the best model (Adjusted R2: 0.72) showing that accessibility to cardiologists and chemical reperfusion centers, and revascularization and angioplasty rates differentially affect the IHD mortality rates geographically. Aging and illiteracy rate presented positive correlation with IHD mortality rate, while income ratio presented negative correlation (p < 0.05). CONCLUSION: Regions of vulnerability were unveiled by the spatial analysis where sociodemographic, exam coverage and accessibility to health variables impacted differently the IHD mortality rates in Paraná state, Brazil. HIGHLIGHTS: The increase in ischemic heart disease mortality rates is related to geographical disparities.The IHD mortality is differentially associated to socioeconomic factors, exam coverage, and access to health.Higher accessibility to chemical reperfusion centers did not necessarily improve patient outcomes in some regions of the state.Clusters of high mortality rate are placed in regions with low amount of cardiologists, income and schooling.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Glob Heart

DOI

EISSN

2211-8179

Publication Date

January 20, 2021

Volume

16

Issue

1

Start / End Page

5

Location

England

Related Subject Headings

  • Spatial Analysis
  • Socioeconomic Factors
  • Myocardial Ischemia
  • Humans
  • Cities
  • Brazil
 

Citation

APA
Chicago
ICMJE
MLA
NLM
de Carvalho Dutra, A., Silva, L. L., Pedroso, R. B., Tchuisseu, Y. P., da Silva, M. T., Bergamini, M., … de Andrade, L. (2021). The Impact of Socioeconomic Factors, Coverage and Access to Health on Heart Ischemic Disease Mortality in a Brazilian Southern State: A Geospatial Analysis. Glob Heart, 16(1), 5. https://doi.org/10.5334/gh.770
Carvalho Dutra, Amanda de, Lincoln Luís Silva, Raíssa Bocchi Pedroso, Yolande Pokam Tchuisseu, Mariana Teixeira da Silva, Marcela Bergamini, João Felipe Hermann Costa Scheidt, et al. “The Impact of Socioeconomic Factors, Coverage and Access to Health on Heart Ischemic Disease Mortality in a Brazilian Southern State: A Geospatial Analysis.Glob Heart 16, no. 1 (January 20, 2021): 5. https://doi.org/10.5334/gh.770.
de Carvalho Dutra A, Silva LL, Pedroso RB, Tchuisseu YP, da Silva MT, Bergamini M, et al. The Impact of Socioeconomic Factors, Coverage and Access to Health on Heart Ischemic Disease Mortality in a Brazilian Southern State: A Geospatial Analysis. Glob Heart. 2021 Jan 20;16(1):5.
de Carvalho Dutra, Amanda, et al. “The Impact of Socioeconomic Factors, Coverage and Access to Health on Heart Ischemic Disease Mortality in a Brazilian Southern State: A Geospatial Analysis.Glob Heart, vol. 16, no. 1, Jan. 2021, p. 5. Pubmed, doi:10.5334/gh.770.
de Carvalho Dutra A, Silva LL, Pedroso RB, Tchuisseu YP, da Silva MT, Bergamini M, Scheidt JFHC, Iora PH, do Lago Franco R, Staton CA, Vissoci JRN, Nihei OK, de Andrade L. The Impact of Socioeconomic Factors, Coverage and Access to Health on Heart Ischemic Disease Mortality in a Brazilian Southern State: A Geospatial Analysis. Glob Heart. 2021 Jan 20;16(1):5.
Journal cover image

Published In

Glob Heart

DOI

EISSN

2211-8179

Publication Date

January 20, 2021

Volume

16

Issue

1

Start / End Page

5

Location

England

Related Subject Headings

  • Spatial Analysis
  • Socioeconomic Factors
  • Myocardial Ischemia
  • Humans
  • Cities
  • Brazil