Socijalno-ekonomske nejednakosti i hronične nezarazne bolesti u Srbiji: nacionalno istraživanje zdravlja
Sažetak
Apstrakt
Uvod/Cilj. Opterećenje društva nezaraznim bolestima predstavlja veliki javno-zdravstveni izazov širom sveta. Iako preventabilne, nezarazne bolesti su danas vodeći uzroci obolevanja, apsentizma, invalidnosti i prevremenog umiranja. Cilj ovog rada bio je da ispita socijalno-ekonomske nejednakosti u prevalenci nezaraznih bolesti u Srbiji. Metode. U studiji su korišćeni podaci nacionalnog istraživanja zdravlja stanovnika Republike Srbije koje je obavljeno 2013. godine. Broj anketiranih osoba starijih od 20 godina bio je 13 765. Povezanost demografskih i socijalno-ekonomskih determinanti zdravlja (nezavisnih varijabli) i prisustva nezaraznih bolesti (zavisne varijable) ispitivana je bivarijantnom i multivarijantnom logističkom regresijom. Statistički značajnim smatrale su se vrednosti p < 0.05. Rezultati. Hipertenzija je najučestalija nezarazna bolest (36.1%). Prevalencija multimorbiditeta bila je 47.1%. Multivarijantna logistička regresija pokazala je da su pol, godine starosti, tip naselja, radni status i obrazovanje povezani sa prisustvom nezaraznih bolesti. Unakrsni odnos (OR) za godine starosti bio je 1.074 [95% interval poverenja (IP) : 1.070–1.077). Kod žena je uočen veći rizik od oboljevanja od nezaraznih bolesti (58.9%) u odnosu na muškarce (OR = 1.589; 95% IP : 1.467–1.726). Ispitanici koji žive na selu su za 14.1% bili pod većim rizikom od oboljevanja od nezaraznih bolesti u odnosu na one koji žive u gradu (OR = 1.141; 95% IP: 1.047–1.244). Unakrsni odnos za nezaposlene bio je 1.227 (95% IP : 1.118–1.346). Ispitanici sa osnovnim obrazovanjem su za 47.1% bili pod većim rizikom od oboljevanja od hronične bolesti (OR = 1.471; 95% IP : 1.281–1.687), dok su oni sa srednjom školom bili pod većim rizikom za 27.7% (OR = 1.277; 95% IP : 1.142–1.428) u odnosu na ispitanike koji imaju visoko obrazovanje. Kada je u pitanju Indeks blagostanja, univarijantna logistička regresija pokazala je da ispitanici koji pripadaju siromašnoj i srednjoj klasi su pod veći rizikom od oboljevanja (OR = 2.031, 95% IP : 1.819–2.267; OR = 1.473, 95% IP : 1.343-1.615) u poređenju sa onima koji pripadaju bogatoj klasi. Multivarijantna logistička regresija nije pokazala statistički značajnu povezanost između Indeksa blagostanja i nezaraznih bolesti. Zaključak: Socijalno-ekonomske nejednakosti u zdravlju veliki su izazov za zdravstvenu politiku, ne samo zato što predstavljaju socijalnu nepravdu nego i zbog toga što se rešavanjem zdravstvenih problema neprivilegovanih grupa stanovništva može uticati na poboljšanje zdravstvenog stanja stanovništva u celini.
Reference
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