Análise das taxas de internação por desnutrição, nos anos de 2010 a 2023, no estado de São Paulo

Abstract

Introduction: Malnutrition remains one of the main public health challenges, influenced by social, economic, environmental, and cultural determinants. Environmental contamination, mainly of soil and water, is a health risk factor and can indirectly contribute to the worsening of nutritional status. Objective: To analyze the relationship between hospitalization rates due to malnutrition and the presence of contaminated areas in the state of São Paulo, between 2010 and 2023. Methods: This is an ecological epidemiological study with a quantitative approach, using publicly available secondary data. Hospitalizations due to malnutrition, registered in the SUS Hospital Information System (SIH/DATASUS), between 2010 and 2023, were analyzed, considering residents of the state of São Paulo. Information on contaminated areas was obtained from the database of the Environmental Company of the State of São Paulo (CETESB). Standardized rates per 10,000 inhabitants were calculated for each Regional Health Department (DRS), using data from the IBGE Demographic Census (2022). Statistical analysis included descriptive and spatial statistics, and univariate and multiple logistic regression models, with a significance level of 5%. Results: During the analyzed period, 34,884,937 hospitalizations were recorded in the state of São Paulo, of which 606,954 were due to malnutrition (1.7%). It was observed that, although the largest number of hospitalizations is concentrated in adults and the elderly between 36 and 99 years of age (74.7%), the greatest relative risk was identified at the extremes of age and in vulnerable groups. Long-lived individuals (>100 years) had a significantly higher chance of hospitalization due to malnutrition (OR 3.929), followed by indigenous peoples (OR 1.200) and females, who, in addition to representing 54% of cases, had an OR of 1.099. Conclusion: Understanding the malnutrition scenario is important to support the planning of intersectoral public policies that consider environmental factors as determinants of health, promoting equity and well-being of the population.