Interseccionalidade de fatores sociodemográficos na ocorrência de fragilidade em uma cidade do sul do brasil, 2021

Abstract

Frailty has a multifactorial cause, and it is plausible that it is influenced by social inequities. Therefore, it is important to understand how sociodemographic conditions affect the health-disease process. This approach is feasible through intersectionality, and thus establish equitable policies according to social inequities. Intersectional analysis would fill gaps still present in the literature, especially regarding the non-biological factors involved in the development of the health stages investigated. Therefore, the objective of this thesis was to analyze the occurrence of frailty according to the intersectionality of sociodemographic variables among aging people in a city in southern Brazil. This is a population-based cross-sectional study. For this work, people aged 50 years or older, living in locations linked to basic health units, were included. The variable depends on frailty assessed using a self-report instrument composed of five components: unintentional weight loss, increased strength and gait speed, low physical activity, and fatigue. The main independent variable was the intersectionality of sociodemographic factors. An intersectional analysis was performed using Poisson regression models using dichotomous stages. The prevalence of frailty was 33.6% (CI: 95% 31.0–36.4) and pre-frailty was 26.1% (CI: 95% 23.7–28.7). Regardless of the sociodemographic characteristic and its category, the majority of the population (>50%) presented some component of frailty (pre-frailty and frailty). A dose-response relationship was observed between intersectionality and frailty. Women, black/brown, low education level and lower economic class had 2.34 times (CI: 95% 1.50–3.76) more frailty than men, white, high education level and higher economic class. The greater the inequality, the greater the prevalence of worsening in self-perception of frailty. An age-adjusted analysis showed the same pattern of increasing worsening in self-perceived frailty as inequality increased. Women, black/brown, low-education and lower economic class, had 1.75 times (CI: 95% 1.50-3.76) more perception of worsening than men, whites, high-education and higher economic class. The social determination of frailty involves an intersection of sociodemographic variables. The results presented by the detailed study for understanding how the pandemic may have affected people's health under analysis of the intersectionality of sociodemographic factors in self-perceived health.