**3. Methodology**

#### **3.1 Study area and population**

This study is part of the project *Population Survey on Living and Health Conditions of the Quilombola Elderly from a City of Baixada Maranhense* (IQUIBEQ Project). This is a cross-sectional, home-based study conducted in 11 CRQs in the municipality of Bequimão, MA. All 11 Quilombola communities are officially recognized as remnants of blacks who escaped slavery by the Palmares Cultural Foundation and the Ministry of Culture (**Figure 1**).

The municipality of Bequimão is inserted in the northern mesoregion and microregion of Maranhense Western Baixada. Geographically, it is located by the edge of the MA-211 road, at a point equidistant from the São Luís capital and the Federal University of Maranhão Campus located in the city of Pinheiro, MA. In 2010, the total area of the municipality of Bequimão was 761.49 km<sup>2</sup> , and the census population was 20,344 inhabitants (67.5% in the rural area and 12.3% elderly). The Human Development Index (HDI)<sup>1</sup> was 0.601, and the gross domestic product per capita was R\$ 2754.37 [17]. The Palmares Foundation recognizes and certifies 11 CRQs: Rio Grande, Ramal de Quindiua, Conceição, Mafra, Santa Rita, Juraraitá, Marajá, Pericumã, Siberia, Sassuy, and Ariquipá [9].

The study population consisted of elderly people ≥60 years old living in the communities. These were selected from the articulation with the Municipal Secretary of Social Assistance and the Community Health Agents (*Agentes Comunitários de Saúde*, ACS) of the respective communities. The ACS conducted a previous survey and built a nominal list with information on gender and date of birth, accounting for 220 elderly. All of these were invited to participate in the research, but after refusals and difficulties to find the elderly in the community in two attempts on different dates, the final population consisted of 208 elderly.

The data collection was carried out on weekdays during commercial hours between July and October 2018. A pilot study was performed to adjust the instruments and train the interviewers. During the collection, the interviewees could consult a manual to clarify doubts, besides being accompanied by the researchers responsible for the research.

**223**

**Figure 1.**

**3.4 Data analysis**

*Socioeconomic and Demographic Characteristics of Living Conditions of Elderly Quilombolas…*

Four questionnaires were applied: a socioeconomic one; one on the population's health conditions, access to and use of health services, and surveillance for noncommunicable chronic diseases and the associated risk factors; a questionnaire on dietary patterns and anthropometry; and the Mini-Mental State Examination (MMSE). The first two were adapted from the 2013 National Health Survey

*Geographic localization of Quilombola communities in Bequimão, Maranhão, Brazil, 2018.*

For this study, only the data obtained from the first questionnaire were used, using the following variables: gender; age; race/skin color; marital status; number of residents per household; ability to read and write; family income in reais (R\$); economic stratum according to social class by the New Criteria Brazil (ABEP) of the year 2018 [18]; receipt of retirement/pension benefit; *bolsa família* benefit; appropriate material used in the construction of the wall (masonry with or without coating), roof (tile, slab), and floor (ceramic, cement); number of rooms; water

The study included individuals ≥60 years old of both sexes and resident in the communities certified by the Palmares Foundation in the municipality of Bequimão and who were able to communicate with the interviewer. Those who are <60 years of age, with inability to communicate with the interviewer, and those with impaired

After collection, data were entered into an Epi Info version 7® statistical program with double data entry technique. Data were then analyzed using the Stata®

*DOI: http://dx.doi.org/10.5772/intechopen.91315*

**3.2 Data collection and research instruments**

(*Pesquisa Nacional de Saúde*, PNS) questionnaire.

supply; drinking water treatment; and sewage.

cognitive function were excluded from the study.

**3.3 Inclusion and exclusion criteria**

<sup>1</sup> The HDI is a social index. It is composed of the agglutination of three previous simple indicators (longevity, income, and education). The use of this indicator in the analysis of living and health conditions is justified due to the simplicity and capacity of these indices to synthesize situations in which whether you need to have a general comparative assessment of well-being, quality of life, or level of socioeconomic status of human collectivities, while allowing them to orient themselves more objectively, and the prioritization of resources and actions of social and health policies for different places [16]. This indicator can take any value between 0 (zero) and 1 (one). The HDI measures the level of human development. Cities can be classified into below HDI (<0.5), medium HDI (0.5 and 0.8), or high HDI (>0.8) [16].

**Figure 1.**

*Quality of Life - Biopsychosocial Perspectives*

city of Baixada Maranhense region.

**3.1 Study area and population**

Foundation and the Ministry of Culture (**Figure 1**).

economic needs.

**3. Methodology**

Ariquipá [9].

consisted of 208 elderly.

responsible for the research.

it is expected that the results of this study point to the health reality of the Quilombola elderly and that this is marked by a set of vulnerabilities and socio-

This study is part of the project *Population Survey on Living and Health Conditions of the Quilombola Elderly from a City of Baixada Maranhense* (IQUIBEQ Project). This is a cross-sectional, home-based study conducted in 11 CRQs in the municipality of Bequimão, MA. All 11 Quilombola communities are officially recognized as remnants of blacks who escaped slavery by the Palmares Cultural

The municipality of Bequimão is inserted in the northern mesoregion and microregion of Maranhense Western Baixada. Geographically, it is located by the edge of the MA-211 road, at a point equidistant from the São Luís capital and the Federal University of Maranhão Campus located in the city of Pinheiro, MA. In 2010, the total area of the municipality of Bequimão was 761.49 km<sup>2</sup>

The study population consisted of elderly people ≥60 years old living in the communities. These were selected from the articulation with the Municipal Secretary of Social Assistance and the Community Health Agents (*Agentes Comunitários de Saúde*, ACS) of the respective communities. The ACS conducted a previous survey and built a nominal list with information on gender and date of birth, accounting for 220 elderly. All of these were invited to participate in the research, but after refusals and difficulties to find the elderly in the community in two attempts on different dates, the final population

The data collection was carried out on weekdays during commercial hours between July and October 2018. A pilot study was performed to adjust the instruments and train the interviewers. During the collection, the interviewees could consult a manual to clarify doubts, besides being accompanied by the researchers

<sup>1</sup> The HDI is a social index. It is composed of the agglutination of three previous simple indicators (longevity, income, and education). The use of this indicator in the analysis of living and health conditions is justified due to the simplicity and capacity of these indices to synthesize situations in which whether you need to have a general comparative assessment of well-being, quality of life, or level of socioeconomic status of human collectivities, while allowing them to orient themselves more objectively, and the prioritization of resources and actions of social and health policies for different places [16]. This indicator can take any value between 0 (zero) and 1 (one). The HDI measures the level of human development. Cities

can be classified into below HDI (<0.5), medium HDI (0.5 and 0.8), or high HDI (>0.8) [16].

and the census population was 20,344 inhabitants (67.5% in the rural area

the gross domestic product per capita was R\$ 2754.37 [17]. The Palmares Foundation recognizes and certifies 11 CRQs: Rio Grande, Ramal de Quindiua, Conceição, Mafra, Santa Rita, Juraraitá, Marajá, Pericumã, Siberia, Sassuy, and

and 12.3% elderly). The Human Development Index (HDI)<sup>1</sup>

,

was 0.601, and

Thus, this study aims to describe the socioeconomic, sanitary, and demographic characteristics of living conditions of the elderly in Quilombola communities in a

**222**

*Geographic localization of Quilombola communities in Bequimão, Maranhão, Brazil, 2018.*

#### **3.2 Data collection and research instruments**

Four questionnaires were applied: a socioeconomic one; one on the population's health conditions, access to and use of health services, and surveillance for noncommunicable chronic diseases and the associated risk factors; a questionnaire on dietary patterns and anthropometry; and the Mini-Mental State Examination (MMSE). The first two were adapted from the 2013 National Health Survey (*Pesquisa Nacional de Saúde*, PNS) questionnaire.

For this study, only the data obtained from the first questionnaire were used, using the following variables: gender; age; race/skin color; marital status; number of residents per household; ability to read and write; family income in reais (R\$); economic stratum according to social class by the New Criteria Brazil (ABEP) of the year 2018 [18]; receipt of retirement/pension benefit; *bolsa família* benefit; appropriate material used in the construction of the wall (masonry with or without coating), roof (tile, slab), and floor (ceramic, cement); number of rooms; water supply; drinking water treatment; and sewage.

#### **3.3 Inclusion and exclusion criteria**

The study included individuals ≥60 years old of both sexes and resident in the communities certified by the Palmares Foundation in the municipality of Bequimão and who were able to communicate with the interviewer. Those who are <60 years of age, with inability to communicate with the interviewer, and those with impaired cognitive function were excluded from the study.

#### **3.4 Data analysis**

After collection, data were entered into an Epi Info version 7® statistical program with double data entry technique. Data were then analyzed using the Stata® version 14 program (StataCorp LP, College Station, Texas, United States). The absolute and relative frequencies of the variables considered in the study were estimated.

#### **3.5 Ethical considerations**

The research was approved by the Research Ethics Committee of the University Hospital of UFMA (favorable opinion: 2,476,488 of January 28, 2018), and all participants signed the informed consent form prior to collection.
