Determinantes sociais de saúde: implicações no cuidado de usuários de saúde mental acompanhados em uma estratégia de saúde da família

Abstract

Primary Health Care sets up the main gateway to health care for users, including those with mental disorders, and it is the bridge of communication between them and the local service network. The social determinants contribute to understanding of the health-disease process and the necessity to overcome the health inequities generated by them. Objective: To identify and report social determinants of health, which are related in the process of analysis of mental health indicators in a Family Health Strategy. Methodology: This is about a descriptive, exploratory, cross-sectional research. Hence were analysed individual and collective records of the information system of the service and later categorized according to the lifestyle of individuals, social and community networks, living and working conditions, socioeconomic and cultural issues and general environmental. Results: the identified population consists 283 mental health users, being 77,03%(n=218) of women aged among 17 and 96 years. As life’s habits, the first level, 15,19%(n=43) make use of tobacco, 1,24%(n=12) of alcohol and 3,88% (n=11) of psychoactive substances. In relation to social and community networks, the second level, 7,77% (n=22) participate in groups of coexistence and 0,35% (n=1) visit family members. The average number of residents per residence varied from two to four people. The third level of the determinants evaluated the health, life and work conditions, being 24,73% (n=70) of retirees/pensioners and 27,20% (n=77) whose are monitoring at specialized services for mental health. The fourth level about socioeconomic and cultural issues and general environmental, the schooling of users in the territory demonstrated that 21,55%(n =61) are with elementary school incomplete, as the general situation of housing 100% of the users has access to electric power, it was identified the predominance of the situation of own and urban residence, with access to the house by asphalt or pavement, and construction of the house in masonry or brick with coating. The sanitation conditions refer to drinking water, the presence of bathrooms with a collection network or septic tank and garbage collection. It evidenced also a lack of information in the records of the system used by the service. Conclusion: this study allowed us to understand the dimension of Social Determinants in Health that concerns the conditions of care of the users in the Family Health Strategy. There is a set of factors individual, collective, political and cultural that influence the determination of the health-disease process of users, as well as the existence of weaknesses in the control of information in electronic records, revealing that there is a contingent of users in the territory whose monitoring is fragile. This situation implies in the planning and practice of actions aimed at guaranteeing the integrality of care to the population included in the territory.