[Regional differences in cardiovascular mortality transition in Brazil, 1980 to 2012]. / Diferenças regionais na transição da mortalidade por doenças cardiovasculares no Brasil, 1980 a 2012.

OBJECTIVE: To estimate the time trend of cardiovascular mortality from 1980 to 2012. METHODS: We performed an ecological time series study of cardiovascular mortality in Brazil. Data regarding deaths were obtained from the Mortality Information System and divided into two groups: deaths from ischemic heart disease (IHD) and deaths from cerebrovascular disorders (CBVD). RESULTS: A -34.73% variation in IHD standardized mortality rates was recorded for Brazil. Concerning specific regions, an increase was observed in the Northeast (117.98%%) and the Midwest (10.26%). IHD mortality rates fell in the Southeast (-53.08%), South (-44.56%) and North (-4.39%). For CBVD, the overall variation was -48.10%. Mortality rates were reduced in most regions: -61.99% in the Southeast, -55.49% in the South, -26.91% in the Midwest, and -20.78% in the North. Only the Northeast recorded an increase in CBVD mortality (13.77%). CONCLUSIONS: We observed an overall declining trend for IHD and CBVD mortality in Brazil from 1980 to 2012, with strong regional variation. Mortality rates were highest in the Southeast and South for both groups of disorders, and lowest in the North and Northeast. Surveillance efforts should take into account the regional differences in epidemiological profile.

[Prevalence of respiratory symptoms in areas of the Federal District, Brazil]. / Prevalência de sintomáticos respiratórios em regiões do Distrito Federal, Brasil.

The identification of individuals with respiratory symptoms (RS) is important for the early detection of tuberculosis. The aim of this study was to estimate the prevalence of RS in three administrative regions of the Federal District, Brazil. For this, we used the 30 by 7 cluster sampling technique proposed by the World Health Organization. Individuals with RS were defined as those aged 15 years or older living in the administrative regions of Estrutural, Itapoã, or Varjão and reporting a cough lasting at least 3 weeks at the date of the interview. The prevalence of RS was 5.7% in Estrutural and Varjão (95% CI: 2.4-9.0) and 4.8% in Itapoã (95%CI: 1.6-7.9), with a design effect close to 1.0. In Estrutural and Itapoã, fewer years of schooling, and in Itapoã and Varjão, lower income, were associated with RS. Cigarette smoking was associated with the presence of RS in all regions. The prevalence of RS in the three administrative regions investigated is consistent with that of other areas with a similar socioeconomic profile.

Medicinal plants and people with tuberculosis: description of care practices in Northern Bahia, 2017. / Plantas medicinais e pessoas com tuberculose: descrição de práticas de cuidado no norte da Bahia, 2017.

OBJECTIVE: To describe medicinal plants used by people with tuberculosis (TB) in municipalities in Northern Bahia, in 2017. METHODS: A descriptive study was carried out with primary data on medicinal plants used by people with TB ≥18 years old, presented according to botanical nomenclature and frequency of consumption. RESULTS: Of the 80 people interviewed, 50 reported consuming some kind of medicinal plant; these were mainly male (34), ≥47 years old (22), of brown/black skin color (34), with up to complete primary education (25), married (26), not economically active (30), earning up to BRL 300/month (26), with coughs (33) and with no previous history of TB (44). Two species stood out in the citations, Chenopodium ambrosioides L. (worm-seed: 23 citations), and Solanum capsicoides All. (cockroach berry: 17 citations). CONCLUSION: There was widespread use of medicinal plants as a TB care practice in six municipalities in Northern Bahia.

Probability of premature death for chronic non-communicable diseases, Brazil and Regions, projections to 2025. / Probabilidade de morte prematura por doenças crônicas não transmissíveis, Brasil e regiões, projeções para 2025.

OBJECTIVE: Objective: To analyze the mortality trends for Chronic Noncommunicable Diseases (NCDs) in the period 2000-2013 and its probability of death until 2025. METHOD: time series analysis of mortality from cardiovascular diseases, cancer, diabetes and chronic respiratory disease, with correction for ill-defined causes and underreporting of deaths and calculation of probability of death. RESULTS: There was an average decline of 2.5% per year in all four major NCDs in Brazil. There was a decline in all regions and federal units. The reduced likelihood of death by 30% in 2000 to 26.1% in 2013 and expected decline to 20.5% in 2025. CONCLUSION: From the trend of reduction is expected to reach Brazil reducing overall goal 25% by 2025.

OBJETIVO: Analisar as tendências de mortalidade por doenças crônicas não transmissíveis (DCNT) no período de 2000 a 2013 e a probabilidade de morte até 2025. MÉTODO: Análise de série temporal de mortalidade das DCNT (doenças cardiovasculares, câncer, diabetes e doenças respiratórias crônicas), com correções para causas mal definidas e sub-registro de óbitos, e a probabilidade de morte por essas doenças. RESULTADOS: Houve declínio médio de 2,5% ao ano no conjunto das quatro principais DCNT no Brasil entre 2000 e 2013, em todas as regiões e unidades federativas. A probabilidade de morte foi reduzida de 30% em 2000 para 26,1% em 2013, e estima-se que caia para 20,5% em 2025. CONCLUSÕES: Dada a tendência de queda, prevê-se que o Brasil atinja a meta global de redução de 25% até 2025.

Demand for health services or professionals among Brazilian adolescents according to the National School Health Survey 2015. / Procura por serviços ou profissionais de saúde entre adolescentes brasileiros, segundo a Pesquisa Nacional de Saúde do Escolar de 2015.

INTRODUCTION: Knowing the profile of individuals who demand health services or professionals could help in the improvement and reorganization of services. However, this subject is still underexplored among adolescents. This study aimed to describe and identify characteristics related to the demand for health services or professionals by Brazilian students. METHODS: Using data from the 2015 National School Health Survey, the prevalence and respective 95% confidence intervals (95%CI) of the demand for health services or professionals among students were estimated, and Poisson regression adjusted by age and region of residence was used to identify the associated factors. RESULTS: More than half of the students demanded for health services or professionals in the last year, with a higher demand among females. The characteristics associated with the outcome were sociodemographic (female, white, private school), family (maternal schooling of 12 years or more, having meals with parents/guardians and parents' knowledge of the adolescent's activities in their free time), risk behaviors (alcohol consumption and sexual intercourse without a condom) and health-related issues (physical violence, wheezing, toothache, hygiene habits, and attitude to one's own weight). CONCLUSION: Organizing health services in a way that takes the particularities of this population into account may provide a space to deal with subjects related to the risks to which it is exposed.

INTRODUÇÃO: O conhecimento sobre o perfil dos indivíduos que procuram serviços ou profissionais de saúde auxilia na melhoria e na reorganização desses atendimentos, entretanto entre adolescentes este tema ainda é pouco explorado. O objetivo deste estudo foi descrever e identificar características relacionadas à procura por serviços ou profissionais de saúde entre escolares brasileiros. MÉTODOS: Por meio dos dados da Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2015, foram estimadas as prevalências, bem como seus respectivos valores do intervalo de confiança de 95% (IC95%), da procura por serviços ou profissionais de saúde pelos escolares; também foi realizada regressão de Poisson ajustada por idade e Região de residência para identificar os fatores associados. RESULTADOS: Mais da metade dos estudantes procurou serviços ou profissionais de saúde no último ano, sendo maior a procura entre o sexo feminino. Associaram-se ao desfecho as características sociodemográficas (sexo feminino, cor branca, escola privada), os aspectos familiares (mãe com 12 anos ou mais de escolaridade, realizar refeições com os pais e conhecimento destes sobre o que os jovens fazem no tempo livre), os comportamentos de risco (consumo de álcool e relação sexual sem preservativo) e as questões relacionadas à saúde (sofrer violência física, chiado no peito, dor de dente, hábitos de higiene e atitude em relação ao próprio peso). CONCLUSÃO: Organizar os serviços de saúde de modo a considerar as particularidades dessa população pode possibilitar um espaço para tratar de assuntos relacionados aos riscos a que os jovens se expõem.

Nutritional status, body image, and their association with extreme weight control behaviors among Brazilian adolescents, National Adolescent Student Health Survey 2015. / Estado nutricional, imagem corporal e associação com comportamentos extremos para controle de peso em adolescentes brasileiros, Pesquisa Nacional de Saúde do Escolar de 2015.

INTRODUCTION: This study aimed to analyze the association between nutritional status, body image perception, and extreme weight control behaviors among adolescents. METHODS: This is an analytical cross-sectional study conducted in Brazil based on the National Adolescent Student Health Survey (Pesquisa Nacional de Saúde do Escolar - PeNSE) of 2015, with adolescents aged 13 to 17 years. Nutritional status and body image perception were the independent variables. The two dependent variables were vomiting or laxative use and use of medicines and other formulas for weight control in the 30 days prior to data collection. We used Poisson regression models for association, with demographic variables for control. RESULTS: 7.4% of adolescents (95%CI 6.7 - 8.2) reported vomiting or using laxatives, with no difference between genders. The prevalence of use of medicines and formulas was higher among boys (7.8%; 95%CI 6.6 - 8.9). The association between nutritional status and extreme behaviors was not significant. However, the prevalence of vomiting or laxative use for adolescents who considered themselves very fat was 2.3 (95%CI 1.1 - 4.7) times higher for boys and 5.3 (95%CI 3.3 - 8.6) times higher for girls, while the use of medicines and formulas was 4.0 (95%CI 2.3 - 7.1) times higher for girls who considered themselves very fat. CONCLUSION: Body image perception seems to have a greater influence on extreme behaviors than nutritional status. Strategies involving health services and schools have great potential to impact the self-esteem and health of students positively.

INTRODUÇÃO: Este estudo objetivou analisar a associação entre estado nutricional, percepção da imagem corporal e comportamentos extremos para controle de peso nos adolescentes. METODOLOGIA: Estudo transversal analítico, realizado no Brasil a partir da Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2015, com adolescentes de 13 a 17 anos. Estado nutricional e percepção da imagem corporal foram as variáveis independentes. As dependentes foram vômito ou uso de laxantes e uso de remédios e outras fórmulas para controle de peso nos últimos 30 dias. Modelos de regressão de Poisson foram empregados para associação, com uso de variáveis demográficas para controle. RESULTADOS: 7,4% dos adolescentes (IC95% 6,7 - 8,2) relataram vômito ou uso de laxantes, sem diferença entre os sexos. A prevalência de uso de remédio e fórmulas foi maior entre meninos (7,8%; IC95% 6,6 - 8,9). A associação entre estado nutricional e comportamentos extremos não foi significativa; entretanto, a prevalência de vômito ou uso de laxantes foi 2,3 (IC95% 1,1 - 4,7) vezes maior em meninos e 5,3 (IC95% 3,3 - 8,6) vezes maior em meninas que se sentiam muito gordos(as), ao passo que uso de remédios e fórmulas foi 4,0 vezes (IC95% 2,3 - 7,1) maior em meninas que sentiam muito gordas. CONCLUSÃO: A percepção da imagem corporal parece ter maior influência na prática dos comportamentos extremos do que o estado nutricional. Estratégias envolvendo serviços de saúde e escolas têm grande potencialidade para ações que impactem positivamente na autoestima e na saúde dos estudantes.

Pap-test coverage in women aged 25 to 64 years old, according to the National Health Survey and the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey, 2013. / Cobertura de exame Papanicolaou em mulheres de 25 a 64 anos, segundo a Pesquisa Nacional de Saúde e o Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico, 2013.

OBJECTIVES: To estimate and describe the coverage of the Pap Smear test reported by women aged 25 to 64 years old from data collected by the National Health Survey (Pesquisa Nacional de Saúde - PNS) and to compare the estimates made by the Surveillance System for Risk and Protective Factors for Chronic Diseases using a Telephone Survey (Vigitel) for the same indicator in the Brazilian capital cities and the Federal District in 2013. METHODS: Based on the data from the PNS and Vigitel, we estimated prevalence and 95% confidence intervals (95%CI) of women who reported having had a Pap test screening in the past 3 years. RESULTS: According to the PNS, 79.4% (95%CI 78.5 - 80.2) of the women had had a cervical cancer screening in the past 3 years in Brazil. Women aged 55 to 64 years old (71.0%, 95%CI 68.7 - 73.3) and without an education or incomplete elementary school (72.1%, 95%CI 70.6 - 73.7) had the lowest prevalence, and 88.4% (95%CI 87.5 - 89.2) received test results within 3 months. There was no difference when comparing the estimates of the Vigitel with the PNS for the capital city and Federal District totals. In the PNS, the prevalence was 83.8% (95%CI 82.8 - 84.7) and in the Vigitel, it was 82.9% (95%CI 81.9 - 83.8). In addition, there were no differences by capital, except for Recife, Boa Vista, and João Pessoa. CONCLUSION: Cervical cancer screening coverage for the target population is below the target of 85%. When comparing the data for the capital city and Federal District totals, we verified that the Vigitel System has been effective in monitoring this indicator, which is similar to PNS estimates.

OBJETIVOS: Estimar e descrever a cobertura do exame Papanicolaou, relatado por mulheres brasileiras entre 25 e 64 anos, na Pesquisa Nacional de Saúde (PNS), e comparar as estimativas do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Sistema Vigitel) para o mesmo indicador nas capitais brasileiras e no Distrito Federal em 2013. MÉTODOS: A partir dos dados da PNS e do Vigitel, foram estimadas as prevalências e os respectivos intervalos de confiança de 95% (IC95%) de mulheres que referiram ter realizado o exame de Papanicolaou nos últimos 3 anos. RESULTADOS: Segundo a PNS, 79,4% (IC95% 78,5 - 80,2) das mulheres realizaram exame Papanicolaou nos últimos 3 anos no Brasil. Mulheres de 55 a 64 anos (71,0%; IC95% 68,7 - 73,3) e sem instrução ou com ensino fundamental incompleto (72,1%; IC95% 70,6 - 73,7) apresentaram as menores prevalências; 88,4% (IC95% 87,5 - 89,2) receberam resultado do exame em até 3 meses. Não houve diferença ao comparar as estimativas do Sistema Vigitel com a PNS para o total das capitais e Distrito Federal. Na PNS, a prevalência foi de 83,8% (IC95% 82,8 - 84,7) e no Vigitel, de 82,9% (IC95% 81,9 - 83,8); além disso, não houve diferenças por capitais, exceto para Recife, Boa Vista e João Pessoa. CONCLUSÃO: A cobertura do exame Papanicolaou para a população-alvo encontra-se abaixo da meta de 85%. Ao comparar os dados para o total de capitais e o Distrito Federal, verificou-se que o Sistema Vigitel tem sido efetivo no monitoramento desse indicador, assemelhando-se às estimativas da PNS.

Hospitalization due to road traffic injuries in Brazil, 2013: hospital stay and costs. / Internações hospitalares por lesões decorrentes de acidente de transporte terrestre no Brasil, 2013: permanência e gastos.

Objetivo: to describe hospitalization rates and to estimate hospital costs and time spent in hospital due to road traffic accidents (RTA) in Brazil, in 2013. Methods: this is an ecological study conducted using data from the Brazilian National Hospital Information System. Results: in 2013, 170,805 hospitalizations due to RTA were funded by the Brazilian National Health System; 78.2% of the individuals were male, 48.6% were from 20 to 39 years old, and 51.9% were motorcyclists; RTA hospitalization rate was of 85.0 hospitalizations/100,000 inhabitants; total cost was BRL 231,469,333.13, with 1,072,557 hospital inpatient days and average stay of 6.3 days in hospital. Conclusion: the magnitude of hospitalization due to RTA was high; victims hospitalized were mainly men, young adults and motorcyclists; average stay in hospital was almost a week, implying significant costs.

Evolution of tobacco use indicators according to telephone surveys, 2006-2014. / Evolução de indicadores do tabagismo segundo inquéritos de telefone, 2006-2014.

The goal of this study was to describe the trend of tobacco-use indicators for adults in Brazilian state capitals. Simple linear regression was used to analyze tobacco-use trends according to data from telephone survey VIGITEL between 2006 and 2014. The prevalence of smokers in Brazil dropped 0.645p.p. per year this period, from 15.6% (2006) to 10.8% (2014). There was a decrease per sex, schooling, major regions, and in most age groups. The prevalence of former smokers dropped from 22.2% (2006) to 21.2% (2014); smoking 20 cigarettes or more per day went from 4.6% (2006) to 3% (2014). Passive smoking at home dropped 0.614p.p. per year since 2009, and was 9.4% in 2014. Passive smoking at the workplace decreased 0.54p.p. a year, reaching 8.9% in 2014. The prevalence trend of smokers is declining for sexes, schooling, and major regions in almost all age groups. This indicates that the global target of 30% reduction in tobacco use until 2025 is possible to be reached, reflecting the effectiveness of control actions for this risk factor in Brazil.

Prevalence of and factors associated with self-reported high blood pressure in Brazilian adults.

OBJECTIVE: To analyze factors associated with self-reported high blood pressure among adults in Brazilian state capitals. METHODS: The study uses data from Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel - Surveillance System of Risk and Protection Factors of Noncommunicable Diseases by Telephone Survey) collected in 2013. Prevalence rates and their respective 95% confidence intervals by gender were estimated according to sociodemographic variables, lifestyle, reported noncommunicable diseases and self-rated health status. Multivariate logistic regression modeling was used to identify variables associated with self-reported high blood pressure with α < 0.05. RESULTS: Prevalence of self-reported high blood pressure among adults living in Brazilian state capitals and the Federal District was 24.1%. The following variables were associated with self-reported high blood pressure: age group, taking 18-24 as reference (all age groups presented increased risk - from 25-34 years [OR = 2.6; 95%CI 2.0-3.4] up to 65 years or more [OR = 28.1; 95%CI 21.7-36.4]); low education level (9 to 11 years of study [OR = 0.8; 95%CI 0.7-0.9] and 12 years or more [OR = 0.6; 95%CI 0.6-0.7]); Black race or skin color (OR = 1.3; 95%CI 1.1-1.5); being a former smoker (OR = 1.2; 95%CI 1.1-1.3); obesity (OR = 2.7; 95%CI 2.4-3.0); diabetes (OR = 2.9; 95%CI 2.5-3.5%), and high cholesterol (OR = 1.9; 95%CI 1.8-2.2). CONCLUSIONS: Approximately one quarter of the adult population living in Brazilian state capitals reported having high blood pressure. Information from Vigitel is useful to monitor high blood pressure and identity its associated factors, supporting public policies for health promotion, surveillance and care.

OBJETIVO: Analisar os fatores associados à hipertensão arterial autorreferida entre adultos nas capitais brasileiras. MÉTODOS: Estudo com os dados do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel) coletados no ano de 2013. Foram estimadas as prevalências e seus respectivos intervalos de confiança 95% por sexo segundo variáveis sociodemográficas, estilos de vida, doenças crônicas relatadas e avaliação do estado de saúde. Modelagem de regressão logística multivariada foi utilizada para identificar as variáveis associadas à hipertensão arterial autorreferida com α < 0,05. RESULTADOS: A prevalência de hipertensão arterial autorreferida entre os adultos residentes nas capitais brasileiras e Distrito Federal foi de 24,1%. Foram identificadas as seguintes associações com hipertensão arterial autorreferida: faixa etária, tomando 18 a 24 anos como referência, todas as faixas etárias apresentaram maior chance - de 25 a 34 anos (RC = 2,6; IC95% 2,0-3,4) até 65 anos ou mais (RC = 28,1; IC95% 21,7-36,4); baixa escolaridade (9 a 11 anos de estudo - RC = 0,8; IC95% 0,7-0,9; e 12 anos ou mais - RC = 0,6; IC95% 0,6-0,7); raça/cor da pele preta (RC = 1,3; IC95% 1,1-1,5); ser ex-fumante (RC = 1,2; IC95% 1,1-1,3); obesidade (RC = 2,7; IC95% 2,4-3,0); diabetes (RC = 2,9; IC95% 2,5-3,5); e colesterol elevado (RC = 1,9; IC95% 1,8-2,2). CONCLUSÕES: Cerca de um quarto da população adulta residente nas capitais brasileiras refere ter hipertensão arterial. As informações do Vigitel são úteis para o monitoramento da hipertensão arterial e identificação de seus fatores associados, subsidiando políticas públicas de promoção, vigilância e atenção à saúde.

Factors associated with chronic back pain in adults in Brazil.

OBJECTIVE: To identify associations of chronic back pain with sociodemographic characteristics, lifestyles, body mass index, self-reported chronic diseases and health assessment, according to sex. METHODS: We analyzed data from the 2013 National Health Survey, estimated the prevalence and their respective 95% confidence intervals (95%CI) of chronic back pain, according to selected variables and performed adjustment by age and education. RESULTS: 18.5% of the Brazilian population reported chronic back pain, 15.5% (95%CI 14.7-16.4) of them being men and 21.1% (95%CI 20.2-22.0) being women. The characteristics that remained associated and statistically significant (p < 0.05) after adjustment, in men, were: age group, higher in men with 65 years or older (ORa = 6.06); low education level; living in rural area; history of smoking, high salt intake, increase in the time of heavy physical activity at work and at home; being overweight (ORa = 1.18) or obese (ORa = 1.26); diagnostic of hypertension (ORa = 1.42), high cholesterol (ORa = 1.60); and worse health assessment in comparison with very good (good [ORa = 1.48]; regular [ORa = 3.22]; poor [ORa = 5.00], very poor [ORa = 8.60]). Among women, they were: increase with age, higher among women with 55-64 years (ORa = 3.64); low education level; history of smoking, regular candy consumption, high salt intake, heavy physical activity at work and at home and increase in the time of these activities; being overweight (ORa = 1.23) or obese (ORa = 1.32); diagnosis of hypertension (ORa = 1.50), high cholesterol (ORa = 1.84); and worse health assessment than very good (good [ORa = 1.43]; regular [ORa = 3.16]; poor [ORa = 5.44], very poor [ORa = 8.19]). CONCLUSIONS: Our findings point out differences by sex and contribute to the knowledge of the panorama of chronic back pain, which, besides affecting individuals, generate negative socioeconomic impacts, by causing work-related disabilities and hindering everyday activities.

OBJETIVO: Identificar associações de dor crônica na coluna com características sociodemográficas, estilos de vida, índice de massa corporal, doenças crônicas autorreferidas e avaliação do estado de saúde, segundo sexo. MÉTODOS: Foram analisados dados da Pesquisa Nacional de Saúde 2013; estimadas as prevalências e seus respectivos intervalos de 95% de confiança (IC95%) da dor crônica na coluna, segundo variáveis selecionadas; e realizado ajuste por idade e escolaridade. RESULTADOS: 18,5% da população brasileira referiram dor crônica na coluna, sendo 15,5% (IC95% 14,7-16,4) em homens e 21,1% (IC95% 20,2-22,0) em mulheres. As características que se mantiveram associadas após o ajuste e estatisticamente significativas (p < 0,05) em homens foram: aumento com a faixa etária, sendo maior entre aqueles com 65 anos ou mais (ORa = 6,06); baixa escolaridade; morar em área rural; histórico de tabagismo, consumo elevado de sal, aumento do tempo de prática de atividade física pesada no trabalho e atividade pesada no domicílio; ter sobrepeso (ORa = 1,18) ou obesidade (ORa = 1,26); diagnóstico de hipertensão (ORa= 1,42), colesterol elevado (ORa = 1,60); e pior avaliação do estado de saúde (bom [ORa = 1,48]; regular [ORa = 3,22]; ruim [ORa = 5,00], muito ruim [ORa = 8,60]). Entre mulheres: aumento com a faixa etária, sendo maior entre as mulheres com 55-64 anos (ORa = 3,64); menor escolaridade; histórico de tabagismo, consumo de doces regularmente, consumo elevado de sal, atividade e aumento do tempo de prática de atividade física pesada no trabalho e atividade pesada no domicílio; ter sobrepeso (ORa = 1,23) ou obesidade (ORa = 1,32); diagnóstico de hipertensão (ORa = 1,50), colesterol elevado (ORa = 1,84); e piora da avaliação do estado de saúde (bom [ORa = 1,43]; regular [ORa = 3,16]; ruim [ORa = 5,44], muito ruim [ORa = 8,19]). CONCLUSÕES: Os achados apontam diferenças por sexo e contribuem no conhecimento do panorama da dor crônica na coluna, que além de afetar o indivíduo, geram impactos socioeconômicos negativos, por ocasionar incapacidades relacionadas ao trabalho e realização de atividades cotidianas.

Risk and protective factors for noncommunicable chronic diseases in adolescents by race/skin color: National Adolescent School-Based Health Survey. / Fatores de risco e proteção de doenças e agravos não transmissíveis em adolescentes segundo raça/cor: Pesquisa Nacional de Saúde do Escolar.

INTRODUCTION:: The race/skin color is an important predictor of health status of the population, as well as a marker of social inequalities. OBJECTIVE:: The aim of this paper was to describe the prevalence of the main risks and the protective factors for chronic diseases in schoolchildren, according to race/skin color differences. METHODS:: Data from the National Adolescent School-Based Health Survey (2012) were used. This is a cross-sectional study carried out in public and private schools. Prevalences were calculated according to the distribution by race/skin color. Prevalence ratios adjusted for age and maternal schooling were analyzed. RESULTS:: White adolescents were younger, studied more frequently in private schools and had mothers with higher levels of education in comparison to the other students. Consumption of beans and fruits was higher among black, brown, and indigenous participants. Physical activity was more frequent among indigenous people. Experimentation with alcohol was higher among white adolescents. Indigenous students reported greater physical violence. Asian and black adolescents reported experiencing greater bullying. CONCLUSION:: Minimizing racial and ethnic disparities in health is necessary to disease prevention and health promotion among adolescents.

Estimate of physical sequelae in victims of road traffic accidents hospitalized in the Public Health System. / Estimativa de sequelas físicas em vítimas de acidentes de transporte terrestre internadas em hospitais do Sistema Único de Saúde.

OBJECTIVES: To describe the profile of the victims of road accidents presenting physical sequelae, according to the criteria established by researchers and analyze the trends in hospitalization for this cause in Brazil, from 2000 to 2013. METHODS: An ecological time-series study was performed using the data from the Hospital Information System of the National Health System (SUS). Trends in hospitalization were estimated using Prais-Winstein regression. RESULTS: During this period, a total of 1,747,191 hospitalizations for traffic accidents were registered; 410,448 were victims with physical sequelae. About 77.7% of them were male subjects, 26.5% belonged to the age group of 20 - 29 years, 46.4% lived in Southeast Brazil, 44.0% were pedestrians, and 31.1% were motorcyclists. In total, 51,189 cases were "confirmed" sequelae (12.5%), and pedestrians accounted for 43.8% of cases. There were 359,259 hospitalizations for the diagnosis of "possible" sequelae, and motorcyclists accounted for 43.3% of these cases. There was a trend of stability for all the patients with confirmed and possible sequelae, but there was a significant rise in hospitalization rates owing to confirmed sequelae among the men in North and Central-West regions. CONCLUSION: The hospitalizations associated with physical sequelae were responsible for about one-fourth of the hospitalizations in the Hospital Information System in the studied period. Most events involved men, young adults, residents in Southeast Brazil, and pedestrians. Hospitalization rates for traffic accidents associated with physical sequelae were stable in Brazil and regions, but a significant increase was observed for confirmed sequelae among men in the North and Central-West regions.

Mortality and potential years of life lost by road traffic injuries in Brazil, 2013.

OBJECTIVE: To estimate the potential years of life lost by road traffic injuries three years after the beginning of the Decade of Action for Traffic Safety. METHODS: We analyzed the data of the Sistema de Informações sobre Mortalidade (SIM - Mortality Information System) related to road traffic injuries, in 2013. We estimated the crude and standardized mortality rates for Brazil and geographic regions. We calculated, for the Country, the proportional mortality according to age groups, education level, race/skin color, and type or quality of the victim while user of the public highway. We estimated the potential years of life lost according to sex. RESULTS: The mortality rate in 2013 was of 21.0 deaths per 100,000 inhabitants for the Country. The Midwest region presented the highest rate (29.9 deaths per 100,000 inhabitants). Most of the deaths by road traffic injuries took place with males (34.9 deaths per 100,000 males). More than half of the people who have died because of road traffic injuries were of black race/skin color, young adults (24.2%), individuals with low schooling (24.0%), and motorcyclists (28.5%). The mortality rate in the triennium 2011-2013 decreased 4.1%, but increased among motorcyclists. Across the Country, more than a million of potential years of life were lost, in 2013, because of road traffic injuries, especially in the age group of 20 to 29 years. CONCLUSIONS: The impact of the high mortality rate is of over a million of potential years of life lost by road traffic injuries, especially among adults in productive age (early mortality), in only one year, representing extreme social cost arising from a cause of death that could be prevented. Despite the reduction of mortality by road traffic injuries from 2011 to 2013, the mortality rates increased among motorcyclists. OBJETIVO: Estimar os anos potenciais de vida perdidos por acidente de transporte terrestre após três anos do início da Década de Ação pela Segurança no Trânsito. MÉTODOS: Foram analisados os dados do Sistema de Informações sobre Mortalidade correspondentes aos acidentes de transporte terrestre, em 2013. Foram calculadas as taxas de mortalidade bruta e padronizada para o Brasil e regiões geográficas. Foi calculada, para o País, a mortalidade proporcional segundo faixas etárias, escolaridade, raça/cor da pele e tipo ou qualidade da vítima enquanto usuária da via pública. Foram estimados os anos potenciais de vida perdidos segundo sexo. RESULTADOS: A taxa de mortalidade, em 2013, foi de 21,0 óbitos por 100 mil habitantes para o País. A região Centro-Oeste apresentou a taxa mais elevada (29,9 óbitos por 100 mil habitantes). A maioria dos óbitos por acidentes de transporte terrestre foi observada no sexo masculino (34,9 óbitos por 100 mil homens). Mais da metade das pessoas que faleceram em decorrência de acidentes de transporte terrestre eram da raça/cor da pele negra, adultos jovens (24,2%), indivíduos com baixa escolaridade (24,0%) e motociclistas (28,5%). A taxa de mortalidade, no triênio 2011 a 2013, apresentou redução de 4,1%, mas aumentou entre os motociclistas. Em todo o País, mais de um milhão de anos potenciais de vida foram perdidos, em 2013, devido aos acidentes de transporte terrestre, especialmente na faixa etária de 20 a 29 anos. CONCLUSÕES: O impacto da alta taxa de mortalidade é de mais de um milhão de anos potenciais de vida perdidos por acidentes de transporte terrestre, principalmente entre adultos em idade produtiva (mortalidade precoce), em apenas um ano, representando extremo custo social decorrente de uma causa de óbito que poderia ser prevenida. Apesar da redução da mortalidade por acidentes de transporte terrestre de 2011 a 2013, as taxas de mortalidade aumentaram entre os motociclistas.

[Time trend in adult obesity indicators in Brazilian state capitals, 2006-2013]. / Tendência temporal dos indicadores de excesso de peso em adultos nas capitais brasileiras, 2006-2013.

The scope of this article is to analyze time trends in excess weight (overweight, obesity and class III obesity) among adults (≥ 18 years of age) in Brazilian capitals between 2006 and 2013. It is a study of temporal trends in excess weight indicators using data from the telephone-based Surveillance System of Risk and Protective Factors for Chronic Non-Communicable Diseases (Vigitel). The Prais regression model was performed. In 2013, the following statistics were observed in the adult population: overweight in 32.2%; obesity in 17.5%, and class III obesity in 1.5%. From 2006 to 2013, there was a significant increase in major indicators, for sex, age group, level of schooling (years) and regions. Overweight and obesity indicators demand attention since they result in a burden on the individual, society and health services.

Self-reported oral health in the Brazilian adult population: results of the 2013 National Health Survey.

Oral diseases are a relevant public health problem in Brazil, because of their prevalence and magnitude in the population. Population-based surveys are essential tools for the election of groups and demands priority attention, . The aim of this paper was to describe the self-reported oral health status of the population, according to sociodemographic factors. A descriptive study was conducted using the National Health Survey data of 2013. Indicators associated with oral hygiene practices and oral health conditions were analyzed. Men, elders, blacks and browns, individuals with no education and with incomplete elementary level, residents in rural areas and in the northeast had the lowest frequencies of the indicators of oral hygiene and health self-perception oral as good or very good. Total loss has affected about 16.0 million. Both total tooth loss as the loss of 13 or more teeth was more frequent among women, individuals aged 60 and older, poorly educated, residents in rural areas. It is concluded that the data from the National Health Research -PNS 2013 reinforce the need for policies and actions that minimize the inequalities in oral health, ensuring access to the most vulnerable population sub-groups according to their health needs.

Contribution of chronic conditions to gender disparities in disability in the older population in Brazil, 2013.

OBJECTIVES: To assess the contribution of chronic conditions to the disability burden in the older men and women in Brazil. METHODS: Data from 10,290 participants of the Brazilian National Health Survey in 2013 aged 60 years or older were used. Disability was defined based on limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL). Binomial additive hazards models were fitted to assess the contribution of chronic conditions to the disability prevalence. RESULTS: Back pain was the most common condition, followed by diabetes and heart diseases in men and arthritis and diabetes in women. Stroke and mental disorders were by far the most disabling conditions in men and women. A higher disability prevalence was observed in women (34.4 %, CI 32.4; 36.2 %) compared to men (28.4 %; CI 25.9; 30.8 %). The most important contributors to the disability prevalence were stroke, back pain, and arthritis among men, and diabetes, heart diseases, and arthritis in women. CONCLUSIONS: Interventions to reduce disability in the older population in Brazil should take into account the gender gap in the occurrence of chronic conditions, focusing on the main contributors to the disability burden.

Progress with the Strategic Action Plan for Tackling Chronic Non-Communicable Diseases in Brazil, 2011-2015. / Avanços do Plano de Ações Estratégicas para o Enfrentamento das Doenças Crônicas não Transmissíveis no Brasil, 2011-2015.

OBJECTIVE: to describe the actions undertaken by the Strategic Action Plan for Tackling Chronic Non-Communicable Diseases (NCDs) in Brazil, from 2011 to 2015. METHODS: the actions were identified through sectorial and interministerial meetings, annual forums, as well as document reviews of publications and laws on government websites. RESULTS: the actions found were: national surveys and monitoring of mortality and risk factor reduction targets; encouragement of physical activity, adequate nutrition and health promotion through the creation of the Health Gym Program (Programa Academia da Saúde); the publication of legislation on tobacco-free environments; free of charge drugs for hypertension, diabetes, and asthma; organization of the emergency service network for cardiovascular diseases; and expanding access to diagnosis and treatment of cancer patients. CONCLUSION: we found progress regarding surveillance, health promotion and comprehensive care; in general, the goals of the Plan are being met.

Injuries from traffic accidents and use of protection equipment in the Brazilian population, according to a population-based study.

The article aims to describe the injuries in traffic according to demographic characteristics, use of protective equipment, use of health services, activity limitations and disabilities. The percentage involvement in traffic accidents with injuries, the percentage of use of protective equipment, use of health services, limitation of daily activities, disability and sequelae, according to educational level, race, color, sex, age and region of residence it estimated.The use of safety belt in the adult population was 79.4%and 50.2% in the front seats and back, respectively; the helmet use among motorcycle drivers and passengers were respectively 83.4 and 80.1. Safety equipment are less used in the North and Northeast and in the countryside. Reported car accident last month 3.1%, being higher in males 4.5%, the people of complete primary schooling and School graduate, young adult and the brown race-color. Among the injured received some form of health care due to this accident 52.4%, were admitted 7.7%. They reported having had limitation of daily activities, disabilities and consequences arising from traffic accidents 14.1%. Car accidents are high in the country.