Analysis of factors associated with the health-illness-mental care process in rural workers in family farming and artisanal fishing

Abstract

The Family Health Strategy (FHS) provides care to the population registered in a territory, and must deal with the singularities in the health-disease-care process, such as those related to mental aspects. This study analyzed the factors that contributed to the health-disease-mental care process in artisanal fishermen and family farmers living in the rural territory of a municipality in Northeastern Brazil. It is an analytical study with a quantitative approach and cross-sectional design with 152 family farmers and/or artisanal fishermen carried out in the municipality of Novo Oriente, Ceará, Brazil. Data collection was from September to October 2020, using a form in the ODK software. The data collected were: sociodemographic, biopsychosocial and assessment of health care; in addition, a screening test for mental distress (SRQ-20) and alcohol abuse (AUDIT), anthropometric measurements, blood pressure measurement and capillary blood glucose were applied. Statistical calculations were performed using the SPSS program, with descriptive analysis using absolute and relative frequency, arithmetic mean and standard deviation of the variables, and analytical analysis using the chi-square test of independence and multivariate logistic regression. The results demonstrated some vulnerabilities: deficient treatment of drinking water (19.5% n=29), existence of environmental problems (25.7% n=39), dissatisfaction with production (26.6% n=40), low family income (34.6% n=47), lack of schools (75% n=114) or daycare centers (88.2% n=134), lack of leisure options (51.3% n=78), and concern about food (37.5% n=57). In the health assessment, the following were detected: high cardiovascular risk based on waist-to-hip ratio (37.8% n=57) and mental distress (23% n=35). Weaknesses in health care and service evaluation were evidenced: no health monitoring (51.3% n=78), lack of knowledge about the ESF (67.1% n=102), distance from home to the basic health unit (UBS) over 5 km (58.2% n=64), lack of professionals at the UBS (59.5% n=78%) and purchase of medicines (87% n=54). In the adjusted logistic regression analysis, there was a correlation between female gender [OR=3.8; 95% CI=1.62 - 8.91; p=0.002] and type of work agriculture and domestic work [OR=6.28; 95% CI=1.21-32.70; p=0.049] with the outcome of mental suffering. Therefore, rural work and mental health, especially related to women, should be highlighted in the monitoring of rural family health teams, seeking to improve access and quality of services.