Prevalência de depressão, falta de acesso, utilização e trajetória nos serviços de saúde por mulheres no período pandêmico

• Ano de defesa: 2025
• Autor(a) principal: Fraga, Emily de Jesus
• Orientador(a): Almeida, Ana Paula Santana Coelho
• Banca de defesa: Sarti, Thiago Dias , Corrêa, Mônica Cola Cariello Brotas
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Espírito Santo; Mestrado em Saúde Coletiva
• Programa de Pós-Graduação: Programa de Pós-Graduação em Saúde Coletiva
• Departamento: Centro de Ciências da Saúde
• País: BR
• Palavras-chave em Português: Depressão; Mulheres; COVID-19; Acesso aos serviços de saúde; Estudos transversais; Access to health services; Cross-sectional studies
• Área do conhecimento CNPq: Saúde Coletiva
• Link de acesso: http://repositorio.ufes.br/handle/10/20788

The COVID-19 pandemic has had negative impacts on the mental health of the population and altered the functioning of health services. Access to care is crucial for prognosis, affecting not only individuals' lives but also collective well-being. In this context, depression stands out as the leading cause of global disability, generating high social costs and putting pressure on health systems. Therefore, it is essential to recognize the factors 6 associated with access to health services by people with this diagnosis. Objectives: To estimate the prevalence and identify the factors associated with the diagnosis of depression and lack of access to medical care, as well as to describe the profile of health service use by women with this diagnosis during the COVID-19 pandemic in the city of Vitória (ES). Methods: A population-based cross-sectional study was conducted with 1,107 women aged 18 years or older, residing in Vitória (ES). Prevalence rates were estimated with respective 95% confidence intervals (95% CI). Bivariate analyses were performed for the three outcomes, and associations involving dichotomous outcomes were assessed using the Rao–Scott chi-square test. Poisson regression was applied to evaluate factors associated with the diagnosis of depression. Results: The prevalence of depression diagnosis was 19.0% (95% CI: 16.8 – 21.4), being more than three times higher among women with negative self-rated health (PR: 3.84; IC95% 2.68-5.50). It was also higher among those without a partner (PR: 1.65; IC95% 1.30 - 2.09) and among those with private health insurance (PR: 1.78; IC95% 1.40 - 2.26). Lack of access to medical care was 4.8% (95% CI: 2.2 - 10.0), with higher proportions among women belonging to economic class D/E (33.3%; 95% CI: 8.4 - 73.1), with low education (25.0%; 95% CI: 6.6 - 61.0) and among those without health insurance (12.1%; 95% CI: 5.7 - 23.7). UBSs were most used among women aged 40 to 59 years (57.4%; 95% CI: 44.2 - 69.6), with elementary school education (80.0%; 95% CI: 54.9-92.9), black (73.1%; 95% CI: 52.2 - 87.1), mixed-race (50.0%; 95% CI: 35.4-64.6), and belonging to class D/E (100%). Private clinics were more frequent among women aged 18 to 39 years (64.2%; 95% CI: 50.2–76.1), with higher education (59.7%; 95% CI: 49.4-69.2), white (71.0%; 95% CI: 60.0 - 81.0) and in class A/B (60.9%; 95% CI: 50.1 - 70.7). Conclusion: The study highlights the impact of the pandemic on the diagnosis of depressive disorders and demonstrates that sociodemographic factors influence both the occupation of spaces in society and the attention given to mental health complaints. In addition, it highlights the fundamental role of the SUS in reducing these inequalities by expanding access to health services, especially for historically marginalized groups