Ambiente construído e sua associação com percepção de saúde em idosos brasileiros: Pesquisa Nacional de Saúde 2013 / Built environment and its association with self-rated health in Brazilian elderly: National Health Survey 2013

RESUMO

Resumo O estudo objetivou investigar a associação entre o ambiente construído e percepção positiva de saúde em idosos das capitais brasileiras. Estudo transversal de base populacional com dados da Pesquisa Nacional de Saúde 2013 e do Observatório das Metrópoles. O desfecho foi percepção positiva de saúde. O ambiente construído foi investigado por meio do Índice de Bem-Estar Urbano (IBEU). As análises foram realizadas por regressão logística multinível (IC95%). Entre os 4.643 idosos investigados, 51,5% reportaram percepção positiva de saúde (IC95% 50,0-52,9). Idosos residentes em capitais com maiores tercis do IBEU apresentaram maiores chances de percepção positiva de saúde (OR 1,42; IC95% 1,08-1,86 (T2); OR 1,78; IC95% 1,35-2,33 (T3)). Quanto às dimensões do IBEU, associaram-se ao desfecho a infraestrutura urbana (OR 1,56 IC95% 1,13-2,16), condições ambientais urbanas (OR 1,49; IC95% 1,10-2,04), condições habitacionais urbanas (OR 1,45; IC95% 1,05-1,99) e serviços coletivos urbanos (OR 1,72; IC95% 1,30-2,27). Evidenciou-se associação positiva entre melhores condições do ambiente construído e percepção de saúde, independente de características individuais. Promover mudanças no ambiente construído pode ser eficaz na melhora dos níveis de saúde, favorecendo o envelhecimento saudável.

ABSTRACT

Abstract The present study aims to investigate the association between the built environment and positive self-rated health among older adults from Brazilian capitals. It is a cross-sectional population-based study, which collected data from the National Health Survey 2013 and the Observatório das Metrópoles. The outcome was a positive self-rated health. The built environment was investigated by the Urban Wellbeing Index (IBEU, in Portuguese). Analyses were performed by multilevel logistic regression (95%CI). Among the 4,643 elderly individuals evaluated in this study, 51.5% reported a positive self-rated health (95%CI 50.0-52.9). Elderly people living in capitals with higher IBEU terciles were more likely to have a positive self-rated health (OR 1.42; 95%CI 1.08-1.86 (T2); OR 1.78; 95%CI 1.35-2.33 (T3)). As for the dimensions of the IBEU, the following were associated with the outcome: urban infrastructure (OR 1.56; 95%CI 1.13-2.16), urban environmental conditions (OR 1.49; 95%CI 1.10-2.04), urban housing conditions (OR 1.45; 95%CI 1.05-1.99), and urban collective services (OR 1.72; 95%CI 1.30-2.27). A positive association was found between better conditions of the built environment and one's perception of health, regardless of individual characteristics. Promoting changes in the built environment can be effective in improving health levels, thus favoring healthy aging.