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.

Health inequalities in Brazilian adolescents: Measuring and mapping gaps in a cross-sectional school-based survey.

Background and Aims: This study aims to describe inequalities in health indicators according to gender, area of residence, and socioeconomic position among Brazilian adolescents. Methods: Cross-sectional study using data from a school-based survey carried out in Brazil in 2019. Twelve health outcomes were evaluated. Dimensions of inequality assessed were gender, area of residence, wealth and subnational region. Results: This study comprises a sample of 124,898 adolescents. The most prevalent outcome was physical inactivity (71.9%) followed by thinking life is worthless (52.6%) and bullying (51.8%). Gender inequalities were more marked for physical inactivity and thinking life is worthless with girls presenting a prevalence more than 20 p.p. higher than boys. In zero-dose HPV, however, the prevalence in girls was 17.7 p.p. lower than in boys. Area of residence and wealth inequalities were smaller than gender disparities. Context presented a relevant role in inequality with analysis stratified by states of the country, revealing high variability in estimates. Conclusions: We highlight the need for attention to disparities between subgroups of the adolescent population, especially for gender inequalities that were the most marked for this age group.

Rural-urban differences in physical activity and TV-viewing in Brazil.

INTRODUCTION: This study aims to compare differences regarding physical activity (PA) indicators and TV viewing according to location of residence and sociodemographic variables in Brazil. METHODS: This cross-sectional study with individuals aged 18 years or older using data from the Brazilian National Health Survey was carried out in 2013. PA (total and domains) and TV viewing (≥3 hours) were measured by self-report. Stratifiers were location of residence, sex, age, wealth quintiles and regions of the country. RESULTS: This study included 60 202 individuals (49 245 from urban areas). In general, total PA was not different according to location of residence (urban 59.4%; rural 57.4%). Higher differences were found for leisure-time PA (urban 24.1%; rural 13.9%), work-based PA (urban 12.9%; rural 21.1%) and TV viewing of more than 3 hours (urban 30.1%; rural 21.4%). The differences between urban and rural areas were enhanced according to sex, age and wealth quintiles. CONCLUSION: The differences between urban and rural areas vary according to PA domains and population groups. To explore specific domains of PA in each location of residence may improve the understanding of the analyzed outcomes in different communities and consequently guide future interventions.

Socioeconomic and Gender Inequalities in Leisure-Time Physical Activity and Access to Public Policies in Brazil From 2013 to 2019.

BACKGROUND: This study aims to describe changes in gender and wealth inequalities in leisure-time physical activity (PA) of Brazilians during a 6-year interval. It also aims to evaluate inequalities regarding PA public programs awareness, participation, and access to public spaces for PA. METHODS: Data from 2 population-based surveys conducted in 2013 and 2019 were used. Leisure-time PA prevalence was assessed considering those reporting ≥150 minutes per week. The authors evaluated gender inequalities calculating differences and ratios, and wealth inequalities using the slope index of inequality and the concentration index- assessing changes over time. RESULTS: National levels of leisure-time PA increased from 2013 to 2019, and an increase in inequalities was observed; women and the poorest groups still presented lower prevalence. A decline in socioeconomic inequalities was observed from 2013 to 2019 regarding the availability of public spaces and awareness about public programs. However, outcomes remained more common among the richest group. Inequalities did not vary for participation in public programs. CONCLUSION: Although leisure-time PA increased from 2013 to 2019 at a national level, there were no improvements in gender inequalities, and wealth inequalities worsened over time. Indicators of public strategies for PA increased for the population, but inequalities remain.

[Time trend in inequalities in smoking and abusive alcohol consumption in Brazil's state capitals]. / Análise temporal da desigualdade em escolaridade no tabagismo e consumo abusivo de álcool nas capitais brasileiras.

This was a time trend study aimed at assessing inequalities in smoking and abusive alcohol consumption, considering schooling as a proxy for socioeconomic status, according to sex and region of Brazil. The study used data from the Risk and Protective Factors Surveillance System for Chronic Non-Comunicable Diseases Through Telephone Interview (Vigitel) survey collected from 2006 to 2017. The outcomes were abusive alcohol consumption and smoking. The inequalities were assessed based on schooling, with double stratification by sex and major geographic region. Weighted linear least squares regression was used to assess the trend in prevalence of outcomes and their inequalities. Prevalence of abusive alcohol consumption increased in women, from 7.8% in 2006 to 12.2% in 2017 and was consistently higher among individuals with more schooling. Prevalence of smoking decreased in both men and women and was consistently higher among those with less schooling. Inequality in alcohol consumption between schooling groups appears to have increased over time, higher in women, but inequality in smoking appears to have decreased. In some regions of Brazil, the measures of inequality suggest stability and in others an increase in inequality in alcohol consumption (Southeast, South, and Central regions in women) and a decrease in smoking (all regions except the Southeast in men; Northeast and Central in women). Despite the strides in smoking reduction, inequalities persist in schooling and are also present in alcohol consumption. The outcomes show opposite trends, so strategies should focus on each of the problems in order to reduce existing inequalities.

Estudo de tendência temporal com o objetivo de avaliar as desigualdades no tabagismo e no consumo abusivo de álcool, considerando a escolaridade como proxy de nível socioeconômico, de acordo com sexo e regiões brasileiras. Foram utilizados dados do Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel) coletados entre 2006 e 2017. Os desfechos foram o consumo abusivo de bebidas alcoólicas e o fumo. As desigualdades foram avaliadas com base na escolaridade, com dupla estratificação por sexo e regiões brasileiras. Para avaliar a tendência das prevalências dos desfechos e suas desigualdades foi usada a regressão linear ponderada pelos quadrados mínimos da variância. A prevalência de consumo abusivo de álcool aumentou em mulheres, de 7,8% (2006) para 12,2% (2017), e foi maior sempre entre os mais escolarizados. A prevalência de tabagismo diminuiu para homens e mulheres e foi maior sempre entre os menos escolarizados. A desigualdade no consumo de álcool entre os grupos de escolaridade parece ter aumentado ao longo do tempo, com maior magnitude entre as mulheres, mas a desigualdade no tabagismo parece estar diminuindo. Em algumas regiões do país, as medidas de desigualdade sugerem estabilidade e em outras um aumento da desigualdade para o consumo de álcool (Sudeste, Sul e Centro-oeste, entre as mulheres) e diminuição para o tabagismo (todas as regiões, exceto Sudeste, entre os homens; Nordeste e Centro-oeste, entre as mulheres). Apesar dos avanços na redução do tabagismo, as desigualdades na escolaridade persistem e estão presentes também em relação ao álcool. Os desfechos têm comportamentos opostos, portanto, estratégias devem ser focadas em cada um dos problemas, a fim de reduzir as desigualdades existentes.

Estudio de tendencia temporal, con el objetivo de evaluar las desigualdades en el tabaquismo y consumo abusivo de alcohol, considerando la escolaridad como proxy de nivel socioeconómico, de acuerdo con el sexo y regiones brasileñas. Se utilizaron datos de Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas No Transmisibles por Entrevista Telefónica (Vigitel), recogidos entre 2006 y 2017. Los resultados fueron el consumo abusivo de bebidas alcohólicas y tabaco. Las desigualdades se evaluaron a partir de la escolaridad, con doble estratificación por sexo y regiones brasileñas. Para evaluar la tendencia de las prevalencias de los resultados y sus desigualdades se utilizó la regresión lineal por mínimos cuadrados ponderados de la variancia. La prevalencia de consumo abusivo de alcohol aumentó en mujeres de 7,8% (2006) a 12,2% (2017) y fue siempre mayor entre los más escolarizados. La prevalencia de tabaquismo disminuyó en hombres y mujeres, y siempre fue mayor entre los menos escolarizados. La desigualdad en el consumo de alcohol entre los grupos de escolaridad parece que ha aumentado a lo largo del tiempo, con mayor magnitud entre las mujeres, pero la desigualdad en el tabaquismo parece estar disminuyendo. En algunas regiones del país, las medidas de desigualdad sugieren estabilidad y en otras un aumento de la desigualdad en el consumo de alcohol (Sudeste, Sur y Centro-oeste, entre las mujeres) y disminución en el tabaquismo (todas las regiones, excepto la Sudeste, entre los hombres; Nordeste y Centro-oeste, entre las mujeres). A pesar de los avances en la reducción del tabaquismo, las desigualdades en la escolaridad persisten y están presentes también en relación con el alcohol. Los resultados tienen comportamientos opuestos, por lo tanto, las estrategias deben centrarse en cada uno de los problemas, a fin de reducir las desigualdades existentes.

Análise temporal da desigualdade em escolaridade no tabagismo e consumo abusivo de álcool nas capitais brasileiras / Time trend in inequalities in smoking and abusive alcohol consumption in Brazil's state capitals / Tendencia temporal de las desigualdades en el tabaquismo y consumo abusivo de alcohol en capitales brasileñas

Resumo Estudo de tendência temporal com o objetivo de avaliar as desigualdades no tabagismo e no consumo abusivo de álcool, considerando a escolaridade como proxy de nível socioeconômico, de acordo com sexo e regiões brasileiras. Foram utilizados dados do Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel) coletados entre 2006 e 2017. Os desfechos foram o consumo abusivo de bebidas alcoólicas e o fumo. As desigualdades foram avaliadas com base na escolaridade, com dupla estratificação por sexo e regiões brasileiras. Para avaliar a tendência das prevalências dos desfechos e suas desigualdades foi usada a regressão linear ponderada pelos quadrados mínimos da variância. A prevalência de consumo abusivo de álcool aumentou em mulheres, de 7,8% (2006) para 12,2% (2017), e foi maior sempre entre os mais escolarizados. A prevalência de tabagismo diminuiu para homens e mulheres e foi maior sempre entre os menos escolarizados. A desigualdade no consumo de álcool entre os grupos de escolaridade parece ter aumentado ao longo do tempo, com maior magnitude entre as mulheres, mas a desigualdade no tabagismo parece estar diminuindo. Em algumas regiões do país, as medidas de desigualdade sugerem estabilidade e em outras um aumento da desigualdade para o consumo de álcool (Sudeste, Sul e Centro-oeste, entre as mulheres) e diminuição para o tabagismo (todas as regiões, exceto Sudeste, entre os homens; Nordeste e Centro-oeste, entre as mulheres). Apesar dos avanços na redução do tabagismo, as desigualdades na escolaridade persistem e estão presentes também em relação ao álcool. Os desfechos têm comportamentos opostos, portanto, estratégias devem ser focadas em cada um dos problemas, a fim de reduzir as desigualdades existentes.

Abstract: This was a time trend study aimed at assessing inequalities in smoking and abusive alcohol consumption, considering schooling as a proxy for socioeconomic status, according to sex and region of Brazil. The study used data from the Risk and Protective Factors Surveillance System for Chronic Non-Comunicable Diseases Through Telephone Interview (Vigitel) survey collected from 2006 to 2017. The outcomes were abusive alcohol consumption and smoking. The inequalities were assessed based on schooling, with double stratification by sex and major geographic region. Weighted linear least squares regression was used to assess the trend in prevalence of outcomes and their inequalities. Prevalence of abusive alcohol consumption increased in women, from 7.8% in 2006 to 12.2% in 2017 and was consistently higher among individuals with more schooling. Prevalence of smoking decreased in both men and women and was consistently higher among those with less schooling. Inequality in alcohol consumption between schooling groups appears to have increased over time, higher in women, but inequality in smoking appears to have decreased. In some regions of Brazil, the measures of inequality suggest stability and in others an increase in inequality in alcohol consumption (Southeast, South, and Central regions in women) and a decrease in smoking (all regions except the Southeast in men; Northeast and Central in women). Despite the strides in smoking reduction, inequalities persist in schooling and are also present in alcohol consumption. The outcomes show opposite trends, so strategies should focus on each of the problems in order to reduce existing inequalities.

Resumen: Estudio de tendencia temporal, con el objetivo de evaluar las desigualdades en el tabaquismo y consumo abusivo de alcohol, considerando la escolaridad como proxy de nivel socioeconómico, de acuerdo con el sexo y regiones brasileñas. Se utilizaron datos de Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas No Transmisibles por Entrevista Telefónica (Vigitel), recogidos entre 2006 y 2017. Los resultados fueron el consumo abusivo de bebidas alcohólicas y tabaco. Las desigualdades se evaluaron a partir de la escolaridad, con doble estratificación por sexo y regiones brasileñas. Para evaluar la tendencia de las prevalencias de los resultados y sus desigualdades se utilizó la regresión lineal por mínimos cuadrados ponderados de la variancia. La prevalencia de consumo abusivo de alcohol aumentó en mujeres de 7,8% (2006) a 12,2% (2017) y fue siempre mayor entre los más escolarizados. La prevalencia de tabaquismo disminuyó en hombres y mujeres, y siempre fue mayor entre los menos escolarizados. La desigualdad en el consumo de alcohol entre los grupos de escolaridad parece que ha aumentado a lo largo del tiempo, con mayor magnitud entre las mujeres, pero la desigualdad en el tabaquismo parece estar disminuyendo. En algunas regiones del país, las medidas de desigualdad sugieren estabilidad y en otras un aumento de la desigualdad en el consumo de alcohol (Sudeste, Sur y Centro-oeste, entre las mujeres) y disminución en el tabaquismo (todas las regiones, excepto la Sudeste, entre los hombres; Nordeste y Centro-oeste, entre las mujeres). A pesar de los avances en la reducción del tabaquismo, las desigualdades en la escolaridad persisten y están presentes también en relación con el alcohol. Los resultados tienen comportamientos opuestos, por lo tanto, las estrategias deben centrarse en cada uno de los problemas, a fin de reducir las desigualdades existentes.