Revista de saude publica最新文献

{"title":"Is the Bland-Altman plot method useful without inferences for accuracy, precision, and agreement?","authors":"Paulo Sergio Panse Silveira, Joaquim Edson Vieira, José de Oliveira Siqueira","doi":"10.11606/s1518-8787.2024058005430","DOIUrl":"10.11606/s1518-8787.2024058005430","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to propose a comprehensive alternative to the Bland-Altman plot method, addressing its limitations and providing a statistical framework for evaluating the equivalences of measurement techniques. This involves introducing an innovative three-step approach for assessing accuracy, precision, and agreement between techniques, which enhances objectivity in equivalence assessment. Additionally, the development of an R package that is easy to use enables researchers to efficiently analyze and interpret technique equivalences.</p><p><strong>Methods: </strong>Inferential statistics support for equivalence between measurement techniques was proposed in three nested tests. These were based on structural regressions with the goal to assess the equivalence of structural means (accuracy), the equivalence of structural variances (precision), and concordance with the structural bisector line (agreement in measurements obtained from the same subject), using analytical methods and robust approach by bootstrapping. To promote better understanding, graphical outputs following Bland and Altman's principles were also implemented.</p><p><strong>Results: </strong>The performance of this method was shown and confronted by five data sets from previously published articles that used Bland and Altman's method. One case demonstrated strict equivalence, three cases showed partial equivalence, and one showed poor equivalence. The developed R package containing open codes and data are available for free and with installation instructions at Harvard Dataverse at https://doi.org/10.7910/DVN/AGJPZH.</p><p><strong>Conclusion: </strong>Although easy to communicate, the widely cited and applied Bland and Altman plot method is often misinterpreted, since it lacks suitable inferential statistical support. Common alternatives, such as Pearson's correlation or ordinal least-square linear regression, also fail to locate the weakness of each measurement technique. It may be possible to test whether two techniques have full equivalence by preserving graphical communication, in accordance with Bland and Altman's principles, but also adding robust and suitable inferential statistics. Decomposing equivalence into three features (accuracy, precision, and agreement) helps to locate the sources of the problem when fixing a new technique.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"58 ","pages":"01"},"PeriodicalIF":2.8,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10878685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139932606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geocoding processes in cohort studies: methods applied in the EpiFloripa Aging.","authors":"Catharina Cavasin Salvador, Adalberto Aparecido Dos Santos Lopes, Danilo Resendes, Fernanda Faccio Demarco, Marcelo Dutra Della Justina, Renato Tibiriçá de Saboya, Cassiano Ricardo Rech, Eleonora d'Orsi","doi":"10.11606/s1518-8787.2023057004976","DOIUrl":"10.11606/s1518-8787.2023057004976","url":null,"abstract":"<p><strong>Objective: </strong>To describe the process and epidemiological implications of georeferencing in EpiFloripa Aging samples (2009-2019).</p><p><strong>Method: </strong>The EpiFloripa Aging Cohort Study sought to investigate and monitor the living and health conditions of the older adult population (≥ 60) of Florianópolis in three study waves (2009/2010, 2013/2014, 2017/2019). With an automatic geocoding tool, the residential addresses were spatialized, allowing to investigate the effect of the georeferencing sample losses regarding 19 variables, evaluated in the three waves. The influence of different neighborhood definitions (census tracts, Euclidean buffers, and buffers across the street network) was examined in the results of seven variables: area, income, residential density, mixed land use, connectivity, health unit count, and public open space count. Pearson's correlation coefficients were calculated to evaluate the differences between neighborhood definitions according to three variables: contextual income, residential density, and land use diversity.</p><p><strong>Result: </strong>The losses imposed by geocoding (6%, n = 240) caused no statistically significant difference between the total sample and the geocoded sample. The analysis of the study variables suggests that the geocoding process may have included a higher proportion of participants with better income, education, and living conditions. The correlation coefficients showed little correspondence between measures calculated by the three neighborhood definitions (r = 0.37-0.54). The statistical difference between the variables calculated by buffers and census tracts highlights limitations in their use in the description of geospatial attributes.</p><p><strong>Conclusion: </strong>Despite the challenges related to geocoding, such as inconsistencies in addresses, adequate correction and verification mechanisms provided a high rate of assignment of geographic coordinates, the findings suggest that adopting buffers, favored by geocoding, represents a potential for spatial epidemiological analyses by improving the representation of environmental attributes and the understanding of health outcomes.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"88"},"PeriodicalIF":2.8,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10681526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136398935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of women who underwent one or more previous cesarean sections according to Nascer no Brasil.","authors":"Marina Barreto Alvarenga, Silvana Granado Nogueira da Gama, Marcos Nakamura-Pereira","doi":"10.11606/s1518-8787.2023057004819","DOIUrl":"10.11606/s1518-8787.2023057004819","url":null,"abstract":"<p><strong>Objective: </strong>To descriptively analyze Brazilian parturient women who underwent previous cesarean section and point out the factors associated with Vaginal Birth After Cesarean (VBAC) in Brazil.</p><p><strong>Methods: </strong>The study used data from women with one, two, or three or more cesarean sections from the survey Nascer no Brasil (Birth in Brazil). Differences between categories were assessed through the chi-square test (χ2). Variables with significant differences (p < 0.05) were incorporated into logistic regression.</p><p><strong>Findings: </strong>Out of the total of 23,894 women, 20.9% had undergone a previous cesarean section. The majority (85.1%) underwent another cesarean section, with 75.5% occurring before the onset of labor. The rate of Vaginal Birth After Cesarean (VBAC) was 14.9%, with a success rate of 60.8%. Women who underwent three or more cesarean sections displayed greater social vulnerability. The chances of VBAC were higher among those who opted for a vaginal birth towards the end of gestation, had a prior vaginal birth, underwent labor induction, were admitted with over 4 centimeters of dilation, and without partner. Receiving care from the private health care system, having two or more prior cesarean sections, obstetric complications, and deciding on cesarean delivery late in gestation reduced the chances of VBAC. Age group, educational background, prenatal care adequacy, and the reason for the previous cesarean section did not result in significant differences.</p><p><strong>Conclusion: </strong>The majority of women who underwent a previous cesarean section in Brazil are directed towards another surgery, and a higher number of cesarean sections is linked to greater social inequality. Factors associated with VBAC included choosing vaginal birth towards the end of gestation, having had a previous vaginal birth, higher cervical dilation upon admission, induction, assistance from the public health care system, absence of obstetric complications, and without a partner. Efforts to promote VBAC are necessary to reduce overall cesarean rates and their repercussions on maternal and child health.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"89"},"PeriodicalIF":2.8,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10681529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between hospitalizations for sensitive conditions and quality of primary care.","authors":"Filipe Malta Dos Santos, César Macieira, Antônio Thomaz Gonzaga da Matta Machado, Elis Mina Seraya Borde, Alzira de Oliveira Jorge, Bruno Abreu Gomes, Alaneir Fatima Dos Santos","doi":"10.11606/s1518-8787.2023057004879","DOIUrl":"10.11606/s1518-8787.2023057004879","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the association between municipal rates of ambulatory care sensitive conditions (ACSC) hospitalization and the quality of primary health care (PHC), socioeconomic, and demographic variables and those related to local characteristics of the health system from 2010 to 2019.</p><p><strong>Method: </strong>Ecological time series study in Brazilian municipalities analyzing the correlation of ACSC hospitalization rates with PHC quality measured by the three cycles of the Primary Care Access and Program for improving primary care access and quality (PMAQ-AB). The study included municipalities whose teams participated in 80% or more of at least two PMAQ-AB cycles. The correlation between standardized ACSC hospitalization rates and PHC quality and other variables was analyzed. Spearman's test was used between the response variable and numerical explanatory variables. Generalized equations estimation was used as a multivariate model associating ACSC hospitalization rates with the other variables over the years.</p><p><strong>Results: </strong>A total of 3,500 municipalities were included in the models. The quality of PHC (PMAQ-AB score) showed an inverse association with the variation in ACSC hospitalization rates. Hospitalization rates fell by -2% per year every ten-point increase in the PMAQ-AB score, adjusted by the remaining variables. A one-unit increase in the beds per 1,000 inhabitants variable had an impact of approximately +6.4% on ACSC hospitalization rates. Regarding population size, larger municipalities had lower ACSC hospitalization rates. Increased PHC coverage and lower socioeconomic inequality were also associated with the reduction in hospitalizations.</p><p><strong>Conclusions: </strong>The reduction in ACSC hospitalization rates over time was associated with an increase in the quality of PHC. It was also associated with a reduction in the number of hospital beds and municipalities with better socioeconomic indicators.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"85"},"PeriodicalIF":2.8,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on the article \"Social desirability bias in qualitative health research\".","authors":"Maria Lúcia Magalhães Bosi","doi":"10.11606/s1518-8787.2023057005419","DOIUrl":"10.11606/s1518-8787.2023057005419","url":null,"abstract":"","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"81"},"PeriodicalIF":2.8,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consumption of drugs for Alzheimer's disease on the Brazilian private market.","authors":"Evani Leite de Freitas, Sabrina Calil-Elias, Rafael Santos Erbisti, Branca Grinberg-Weller, Elaine Silva Miranda","doi":"10.11606/s1518-8787.2023057005128","DOIUrl":"10.11606/s1518-8787.2023057005128","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the consumption of drugs for Alzheimer's disease on the Brazilian private market and its geographical distribution from 2014 to 2020.</p><p><strong>Methods: </strong>National data from the Brazilian National System of Controlled Product Management were used, regarding sales of donepezil, galantamine, rivastigmine, and memantine from January 2014 to December 2020. Sales data were used as a proxy for drug consumption and expressed as defined daily dose/1,000 inhabitants/year at national, regional, federative unit and microregion levels.</p><p><strong>Results: </strong>Drug consumption went from 5,000 defined daily doses/1,000 inhabitants, in 2014, to more than 16,000/1,000 inhabitants, in 2020, and all federative units showed positive variation. The Brazilian Northeast had the highest cumulative consumption in the period but displayed microregional disparities while the North region had the lowest consumption. Donepezil and memantine were the most consumed drugs, with the highest growth in consumption from 2014 to 2020.</p><p><strong>Conclusion: </strong>The consumption of medicines indicated to treat Alzheimer's disease tripled in Brazil between 2014 and 2020, which may relate to the increase in the prevalence of the disease in the country, greater access to health services, and inappropriate use. This challenges managers and healthcare providers due to population aging and the increased prevalence of chronic-degenerative diseases.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"83"},"PeriodicalIF":2.8,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uber use after alcohol consumption among car/motorcycle drivers in ten Brazilian capitals.","authors":"Érika Carvalho de Aquino, Otaliba Libânio de Morais Neto","doi":"10.11606/s1518-8787.2023057005147","DOIUrl":"10.11606/s1518-8787.2023057005147","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to measure the proportion of Uber use instead of drinking and driving in ten Brazilian capitals, in 2019.</p><p><strong>Methods: </strong>A cross-sectional survey was developed in ten Brazilian capitals. Data were collected in agglomeration points (AP) and sobriety checkpoints (SC). Based on responses to a standardized questionnaire, the proportion of drivers who used Uber instead of drinking and driving was measured for total sample of each methodology and stratified by municipality, age group, gender, education level, and type of vehicle. Fisher's exact test was used to make comparisons between the strata.</p><p><strong>Results: </strong>A total of 8,864 drivers were interviewed. The most used means of transport to replace driving after drinking alcohol was the Uber system (AP: 54.6%; 95%CI: 51.2-58.0. SC: 58.6%; 95%CI: 55.2-61.9). Most of these users were aged from 18 to 29 years, women, with at least one higher education degree. According to the AP methodology, the highest magnitude of this indicator was found in Vitória (ES) (71.0%; 95%CI: 63.5-77.5), whereas the lowest was observed in Teresina (PI) (33.1%; 95%CI: 22.7-45.5). According to the SC methodology, the highest magnitude of the indicator was also found in Vitória (ES) (78.3%; 95%CI: 68.8-85.5), whereas the lowest was observed in Boa Vista (RR) (36.6%; 95%CI: 26.8-47.7).</p><p><strong>Conclusion: </strong>In Brazilian capitals, the study showed higher proportions of Uber use instead of drinking and driving. This type of scientific evidence on factors associated with road traffic injuries presents the potential to guide public health interventions.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"86"},"PeriodicalIF":2.8,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136398937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food and Nutrition Surveillance System markers predict diet quality.","authors":"Maria Laura da Costa Louzada, Vanessa Del Castillo Silva Couto, Fernanda Rauber, Claudia Raulino Tramontt, Thanise Sabrina Souza Santos, Bárbara Hatzlhoffer Lourenço, Patrícia Constante Jaime","doi":"10.11606/s1518-8787.2023057005087","DOIUrl":"10.11606/s1518-8787.2023057005087","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the performance of food consumption markers of the Food and Nutrition Surveillance System (Sisvan) in assessing the overall dietary quality.</p><p><strong>Methods: </strong>The study was carried out based on the reproduction of responses to markers in 24-hour recall data from 46,164 individuals aged ≥ 10 years, from the 2017-2018 Household Budget Survey (POF). Seven Sisvan markers were evaluated, and two scores were calculated for each participant, based on the sum of the number of healthy food markers (beans, fruits, and vegetables, ranging from 0 to 3) and unhealthy (hamburgers/sausages, sweetened beverages, instant noodles/salt snacks/crackers, stuffed cookies/sweets/candies, ranging from 0 to 4) consumed. Linear regression analyses were used to assess the association between scores and diet quality indicators (ultra-processed foods, dietary diversity, and levels of saturated and trans fat, added sugar, sodium, potassium, and fiber in the diet).</p><p><strong>Results: </strong>The score of healthy eating markers increased significantly with increasing dietary diversity and potassium and fiber contents in the diet, while the opposite trend was observed for the densities of added sugar, sodium, saturated and trans fat (p < 0.001). The score of unhealthy eating markers increased significantly with the increase in the consumption of ultra-processed foods and densities of added sugar, saturated and trans fat levels in the diet, while an inverse trend was observed for potassium and fiber (p < 0.001). The joint analysis of the combination of the two marker scores showed that individuals with better performance (3 in the healthy food score, and 0 in the unhealthy food score) have a lower number of inadequacies in nutrient consumption.</p><p><strong>Conclusion: </strong>Sisvan food consumption markers, quickly and easily applied and already incorporated into the Brazilian public health system, have good potential to reflect the overall dietary quality.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"82"},"PeriodicalIF":2.8,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infant mortality in the municipality of São Paulo: trend and social inequality (2006-2019).","authors":"Katia Cristina Bassichetto, Margarida Maria de Azevedo Tenório Lira, Edige Felipe de Sousa Santos, Ivan Arroyave, Samantha Hasegawa Farias, Marilisa Berti de Azevedo Barros","doi":"10.11606/s1518-8787.2023057004791","DOIUrl":"10.11606/s1518-8787.2023057004791","url":null,"abstract":"<p><strong>Objective: </strong>Considering the published evidence on the impact of recent economic crises and the implementation of fiscal austerity policies in Brazil on various health indicators, this study aims to analyze how the trend and socio-spatial inequality of infant mortality behaved in the municipality of São Paulo from 2006 to 2019.</p><p><strong>Methods: </strong>This is an ecological study with a temporal trend analysis that was developed in municipality of São Paulo, using three residence area strata differentiated according to their social vulnerability following the 2010 São Paulo Social Vulnerability Index. Infant mortality rate, as well as neonatal, and post-neonatal mortality rates, were calculated for each social vulnerability stratum, each year in the period, and for the first and last three triennia. Temporal trends were analyzed by the Prais-Winsten regression model and inequality magnitude, by rate ratios.</p><p><strong>Results: </strong>We found a decline in infant mortality rate and its components from 2006 to 2015, greater in the stratum with low social vulnerability and in the post-neonatal period when compared to the neonatal one. This decline ended in 2015, stagnating in the next period (2016-2019). Our analysis of infant mortality inequality across social vulnerability stratum showed a significant increase from the initial to the final triennia in the analyzed period; rate ratios increased from 1.36 to 1.48 in the high stratum (compared to the low social vulnerability stratum), and from 1.19 to 1.32 between the medium and low social vulnerability strata.</p><p><strong>Conclusions: </strong>The observed stagnation of infant mortality rate decline in 2015 and the increase in socio-spatial inequality point to the urgent need to reformulate current public policies to reverse this situation and reduce inequalities in the risk of infant death.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"84"},"PeriodicalIF":2.8,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136398936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Were public interventions relevant for containing the covid-19 pandemic in Brazil in 2020?","authors":"Vitória Berg Cattani, Thaís Araujo Dos Santos, Marcelo Ribeiro-Alves, Julio Castro-Alves","doi":"10.11606/s1518-8787.2023057005030","DOIUrl":"10.11606/s1518-8787.2023057005030","url":null,"abstract":"<p><strong>Objective: </strong>Flattening the curve was the most promoted public health strategy worldwide, during the pandemic, to slow down the spread of the SARS-CoV-2 virus, and, consequently, to avoid overloading the healthcare systems. In Brazil, a relative success of public policies was evidenced. However, the association between public policies and the \"flatten the curve\" objectives remain unclear, as well as the association of different policies to reach this aim. This study aims to verify if the adoption of different public policies was associated with the flattening of the infection and death curves by covid-19 first wave in 2020.</p><p><strong>Methods: </strong>Data from the Sistema de Informação da Vigilância Epidemiológica da Gripe (Influenza Epidemiological Surveillance Information System - SIVEP-Gripe) and the Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics - IBGE) were used to compute standardized incidence and mortality rates. The Oxford Covid-19 Government Response Tracker (OxCGRT) was used to obtain information about governmental responses related to the mitigation of pandemic effects, and the Human Development Index (HDI) was used as a measure of socioeconomic status. A non-linear least-square method was used to estimate parameters of the five-parameter sigmoidal curve, obtaining the time to reach the peak and the incremental rate of the curves. Additionally, ordinary least-square linear models were used to assess the correlation between the curves and the public policies adopted.</p><p><strong>Results: </strong>Out of 51 municipalities, 261,326 patients had SARS-CoV-2 infection. Stringency Index was associated with reducing covid-19 incremental incidence and death rates,in addition to delaying the time to reach the peak of both pandemic curves. Considering both parameters, economic support policies did not affect the incidence nor the mortality rate curves.</p><p><strong>Conclusion: </strong>The evidence highlighted the importance and effectiveness of social distancing policies during the first year of the pandemic in Brazil, flattening the curves of mortality and incidence rates. Other policies, such as those focused on economic support, were not effective in flattening the curves but met humanitarian and social outcomes.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"77"},"PeriodicalIF":2.8,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10609658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71485447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}