SOCIAL INEQUALITIES AND PREVENTIVE PRACTICES AMONG WOMEN IN SAO PAULO / BRAZIL

INTRODUCTION: Population-based health surveys are conducted to provide information about health status, access to health care and inequalities in health. Currently, with over 6 million women, Sao Paulo/Brazil has characteristics of a large urban center where social inequality in access to health services require attention. The objective was to describe the coverage of preventive practices among women, as well as the involvement of the Brazilian health care system - SUS in the realization of the exams.

METHODS: Analyzing data from the Sao Paulo Health Survey (“ISA-Capital-2008”) a cross sectional population-based study, we calculated prevalence estimates, prevalence ratios, 95% confidence intervals and chi-square tests (Rao-Scott) to verify the existence of association between the examinations (prenatal care, mammography and Pap smear screening) and the involvement of the Brazilian health care system - SUS, according to education, in four different levels. Stata 11 was used considering the complex sample design of the survey.

RESULTS: Higher prevalence of mammography was observed in higher levels of education (p<0.001). Nevertheless, for prenatal exam (p=0.501) and Pap smear screening (p=0.224), no significant differences were observed. Regarding the contribution of SUS in the examinations, we found significant inverse association with education level, as a result, in categories with less education, the participation of SUS is greater.

CONCLUSIONS:  The government has been relying on the incorporation of strategies to generate opportunities for access to health services for all women, in a less unequal manner and SUS has great importance in this process.