Inequalities in Leisure-Time Physical Activity and Television Viewing According to Age Among a Brazilian Adult Population.

BACKGROUND: The present study aims to estimate leisure-time physical activity and television (TV) viewing curves according to age stratified by sex, area of residence, and socioeconomic position. METHODS: Using data from the Brazilian National Health Survey, we estimated the prevalence of leisure-time physical activity and TV viewing according to continuous age. The estimates were calculated using fractional polynomials and stratified by sex, wealth, skin color, and area of residence. RESULTS: The sample included 87,376 adults (aged 18 y or over). In general, leisure-time physical activity decreased according to age while TV viewing increased. Regarding behavior of curves according to stratifiers, for leisure-time physical activity the disadvantaged groups maintained a pattern of low physical activity across all age groups or presented the decrease earlier when compared to groups in social advantage. On the other hand, for TV viewing, women presented an increase in prevalence before men, and individuals living in the urban area and the wealthiest group were those with a higher increase according to age. CONCLUSIONS: Our findings may help researchers and policymakers further explore inequalities in physical activity across life in different settings, as well as develop sensitive cultural actions to support more vulnerable people to adopt public health recommendations.

Hospital admissions in the first year of life: inequalities over three decades in a southern Brazilian city.

BACKGROUND: Hospital admissions in infancy are declining in several countries. We describe admissions to neonatal intensive care units (NICU) and other hospitalizations over a 33-year period in the Brazilian city of Pelotas. METHODS: We analysed data from four population-based birth cohorts launched in 1982, 1993, 2004 and 2015, each including all hospital births in the calendar year. NICU and other hospital admissions during infancy were reported by the mothers in the perinatal interview and at the 12-month visit, respectively. We describe these outcomes by sex of the child, family income and maternal skin colour. RESULTS: In 1982, NICUs did not exist in the city; admissions into NICUs increased from 2.7% of all newborns in 1993 to 6.7% in 2015, and admission rates were similar in all income groups. Hospitalizations during the first year of life fell by 29%, from 23.7% in 1982 to 16.8% in 2015, and diarrhoea admissions fell by 95.2%. Pneumonia admissions fell by 46.3% from 1993 to 2015 (no data available for 1982). Admissions due to perinatal causes increased during the period. In the poorest income quintile, total admissions fell by 33% (from 35.7% to 23.9%), but in the richest quintile these remained stable at around 10%, leading to a reduction in inequalities. Over the whole period, children born to women with black or brown skin were 30% more likely to be admitted than those of white-skinned mothers. CONCLUSIONS: Whereas NICU admissions increased, total admissions in the first year of life declined by nearly one-third. Socioeconomic disparities were reduced, but important gaps remain.

Low birthweight and preterm birth: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982-2015.

BACKGROUND: Despite positive changes in most maternal risk factors in Brazil, previous studies did not show reductions in preterm birth and low birthweight. We analysed trends and inequalities in these outcomes over a 33-year period in a Brazilian city. METHODS: Four population-based birth cohort studies were carried out in the city of Pelotas in 1982, 1993, 2004 and 2015, with samples ranging from 4231 to 5914 liveborn children. Low birthweight (LBW) was defined as <2500 g, and preterm birth as less than 37 weeks of gestation. Information was collected on family income, maternal skin colour and other risk factors for low birthweight. Multivariable linear regression was used to estimate the contribution of risk factors to time trends in birthweight. RESULTS: Preterm births increased from 5.8% (1982) to 13.8% (2015), and LBW prevalence increased from 9.0% to 10.1%, being higher for boys and for children born to mothers with low income and brown or black skin colour. Mean birthweight remained stable, around 3200 g, but increased from 3058 to 3146 g in the poorest quintile and decreased from 3307 to 3227 g in the richest quintile. After adjustment for risk factors for LBW, mean birthweight was estimated to have declined by 160 g over 1982-2015 (reductions of 103 g in the poorest and 213 g in the richest quintiles). CONCLUSIONS: Data from four birth cohorts show that preterm births increased markedly. Mean birthweights remained stable over a 33-year period. Increased prevalence of preterm and early term births, associated with high levels of obstetric interventions, has offset the expected improvements due to reduction in risk factors for low birthweight.