Transtornos mentais em comunidades quilombolas rurais do Norte de Minas Gerais

Abstract

Quilombola communities in Brazil occupy territories in all biomes of the country, occupying rural and urban areas, representing a sociocultural diversity with deep links with Brazilian ecosystems. Quilombo is a historical, political, cultural and identity category that was forged within the scope of the intense struggles waged against the invisibilities and oppressions historically suffered. With regard to health conditions, social inequality has direct effects on access to care and worsening health problems in this group. In fact, many health indicators are worse in rural areas compared to urban areas, including those related to mental health. Studies suggest the existence of a relationship between the precarious living conditions and the psychological suffering of quilombolas. The objective of the present work was to evaluate the prevalence and factors associated with mental health problems in quilombola communities located in territories of the Northern Health Macroregion, in the State of Minas Gerais, Brazil. It was a population-based cross-sectional study, carried out in 2019. For data collection, a questionnaire based on the National Health Survey carried out in 2013 was used. For data referring to Common Mental Disorders (CMD), the Self Reporting Questionnaire was used (SRQ-20) and for data on alcohol use disorder, the Alcohol Use Disorder Identification Test (AUDIT) was used. Descriptive analyses, bivariate analysis and multiple analysis were performed, using binary logistic regression to estimate the magnitude of associations through the prevalence ratio. The prevalence of CMD was 38.7%. There was a greater chance of CMD among female quilombolas (OR: 2.69; 95% CI 2.00-3.62), with 1 to 8 years of study (OR: 1.70; 95% CI 1.15-2, 51), family income between 1 and 1.5 minimum wage (OR: 2.51; 95%CI 1.60- 3.94); who suffered discrimination in health services (OR: 2.44; 95%CI 1.44-4.13); with self reported lung disease (OR: 2.10; 95%CI 1.25-3.54), heart disease (OR: 1.58; 95%CI 1.01-2.50) and chronic renal failure (OR: 1 .97; 95%CI 1.08-3.94), and with negative self-perceived health (OR: 3.07; 95%CI 2.31-4.07). Regarding alcohol use disorder, it was found that 21.3% of respondents had risky consumption, harmful use and probable alcohol dependence. There was a greater chance of alcohol use disorder among quilombola men aged between 18 and 39 years old (OR= 3.98 – 95% CI 1.65;9.57) and 40 to 59 years old (OR= 3.62 – CI 95% 1.53-8.57), who suffered discrimination in health services (OR=3.38 – 95% CI 1.00-11.71) and self reported depression (OR=2.79 – 95 CI % 1.24-6.27). The high prevalence of CMD and alcohol use disorder demonstrate the need for mental health care policies aimed at vulnerable populations, such as quilombola communities, in order to mitigate mental suffering and encourage professional care contextualized with the singularities of the conditions. life and health of this population group.