Changes in prevalence and in educational inequalities in Brazilian health behaviors between 2013 and 2019.

Considering the relevance of health behaviors for chronic diseases prevalence and mortality and the increase in income concentration observed in the world and in Brazil, this study aimed to evaluate the changes in the prevalence and in the educational inequalities of Brazilian adult health behaviors between 2013 and 2019. We analyzed data of 49,025 and 65,803 adults (18-59 years of age) from the Brazilian National Health Survey (PNS), 2013 and 2019. Prevalence of health behaviors (smoking, alcohol intake, diet, physical activity and sedentarism) were estimated for three educational strata, for both surveys. Prevalence ratios (PR) between year of survey and between educational strata were estimated by Poisson regression models. Significant reductions were found in the prevalence of smoking, physical inactivity, sedentarism, insufficient consumption of fruits, and the excessive consumption of sweetened beverages. However, an increase was observed in alcohol consumption and binge drinking; vegetable consumption remained stable. Contrasting the favorable change in some behaviors, inequalities among schooling strata remained very high in 2019, specially for smoking (PR = 2.82; 95%CI: 2.49-3.20), passive smoking (PR = 2.88; 95%CI: 2.56-3.23) and physical inactivity (PR = 2.02; 95%CI: 1.92-2.13). There was a significant increase in the educational inequality regarding physical inactivity (21%), insufficient intake of fruit (8%) and in the frequent consumption of sweetened beverages (32%). The persistence and enlargement of inequalities highlight the behaviors and social segments that should be special targets for policies and programs focused in promoting healthy lifestyles.

Cancer surveillance in Mato Grosso, Brazil: methodological and operational aspects of a university extension/research project.

OBJECTIVE: To describe the methodological and operational aspects of the "Project for surveillance of cancer and its associated factors: population-based and hospital-based registry" (VIGICAN), in the state of Mato Grosso (MT), Brazil. METHODS: VIGICAN was divided into two projects: a university extension one, which updated the data from the Population-based Cancer Registry (PBCR) of MT in the 2008-2016 period; and a research project, which collected primary data, through individual interviews and analysis of medical records of people with a diagnosis of cancer, aged 18 years or older, treated at reference hospitals for oncology. To analyze the factors associated with cancer, the following variables were collected: socioeconomic and demographic, social support, health status and behavior, and environmental exposure. RESULTS: In the 2008-2016 period, approximately one hundred thousand cases of cancer (incident and prevalent) were reported in the PBCR Cuiabá and PBCR Interior. After validation procedures, 50 thousand incident cases were elected. The survey interviewed 1,012 patients, 38.2% living in the municipalities of Cuiabá and Várzea Grande, 60.4% in small cities of the state, and 1.4% in other states. Preliminary data showed that the majority were women (55.0%) and younger than 60 years of age (54.3%). Among the interviewees, 7.2% reported smoking tobacco, 15.5% consumed alcoholic beverages (15.5%), and 32.7% lived nearby crops. CONCLUSION: The development of these projects allowed the integration of education with health services and will enable the recognition of specificities and different exposure scenarios and factors associated with cancer in the Mato Grosso territory.

Cancer mortality in the State of Mato Grosso from 2000 to 2015: temporal trend and regional differences.

OBJECTIVE: To analyze the trend of standardized cancer mortality rate in the state of Mato Grosso according to health regions, from 2000 to 2015. METHODS: Ecological time series study with data on deaths by cancer from the Mortality Information System. The rates were standardized using direct method and calculated by year and health regions. The annual percentage changes (APC) and respective confidence interval (95%CI) were obtained through simple linear regression. Thematic maps were built to show the spatial distribution of rates. RESULTS: There were 28,525 deaths by cancer registered in Mato Grosso, with the main types being lung, prostate, stomach, breast and liver cancer. The highest mortality rates were found in regions Médio Norte, Baixada Cuiabana and Sul Mato-Grossense. From 2000 to 2015, an upward trend was seen in the mortality rate by cancer in Mato Grosso (APC=0.81%; 95%CI 0.38-1.26), and in four health regions, Garças Araguaia (APC=2.27%; 95%CI 1.46-3.08), Sul Mato-Grossense (APC=1.12%; 95%CI 0.28-1.97), Teles Pires (APC=1.93%; 95%CI 0,11-3,74) and Vale dos Arinos (APC=2.61%; 95%CI 1.10-4.70), while the other regions remained stable. CONCLUSION: In the state of Mato Grosso and in the four health regions, cancer mortality rate showed a growing trend. The results point to the need to consider regional differences when thinking about actions for cancer prevention, control and assistance.

Potential years of life lost to cancer in Mato Grosso, stratified by sex: 2000 to 2019.

OBJECTIVE: To estimate the potential years of life lost (PYLL) to cancer in the State of Mato Grosso, from 2000 to 2019, stratified by sex, according to age groups and cancer types. METHODS: It is a quantitative study with an ecological approach developed from secondary data, using the PYLL and its derivatives. RESULTS: In the period analyzed, deaths from cancer in Mato Grosso resulted in 680,338 PYLL before the age of 80, with a variation of 82.5%. Of this total, 52.7% were assigned to males. The rate of the PYLL for cancer before the age of 60 was 70.9% in males, and 80.1% among women. The rates of PYLL increased in the period and showed slightly higher values in males. In the analysis according to age group, the rates of PYLL were also higher in males, except between the ages of 30 and 49. Lung cancers and lymphomas/leukemias resulted in greater losses of PYLL among men and female specific cancers (breast, cervical and uterine, and ovarian cancer) accounted for 36.26% of the PYLL among women, with variability per age groups. CONCLUSION: In Mato Grosso, the PYLL indicator for cancer presented unfavorable evolution between 2000 and 2019, with greater damage for males and for the younger population. Leukemias, lymphomas, and lung and breast cancers were the main causes for the PYLL.

Incidence, mortality and survival of prostate cancer in two municipalities with a high human development index in Mato Grosso, Brazil.

OBJECTIVE: To analyze the incidence, mortality and survival of prostate cancer in Cuiabá and Várzea Grande, Brazil from 2000 to 2016. METHODS: Data from the Population-based Cancer Registry and the Mortality Information System were used. Mortality and incidence trends were analyzed using joinpoint regression models by age group. Survival analyses were performed using the Kaplan-Meier method, and hazard ratio was estimated by age group. RESULTS: From 2000 to 2016, 3,671 new cases and 892 deaths for prostate cancer were recorded. The average incidence and mortality rates were 87.96 and 20.22 per 100,000, respectively. Decreasing incidence trend was noted for all age groups from 2006 to 2016 (APC=-3.2%) and for men with 80+ years of age from 2000 to 2016 (APC=-3.0%), and increasing mortality trend for men 60-69 years of age from 2000 to 2009 (APC=3.2%). The specific five-year survival rate for prostate cancer was 79.6% (95%CI 77.2-81.9), and the rate decreased with advanced age (HR=2.43, 95%CI 1.5-3.9, for those 70 to 79 years old and HR=7.20, 95%CI 4.5-11.5, for those 80 or older). CONCLUSION: The incidence rate of prostate cancer showed a decreasing trend from 2006 for all age groups; the mortality rate was stable in that period, and worse prognosis was observed in men 70 years or older.

Changes in prevalence and in educational inequalities in Brazilian health behaviors between 2013 and 2019 / Mudanças na prevalência e nas desigualdades educacionais nos comportamentos de saúde no Brasil entre 2013 e 2019 / Cambios en la prevalencia y en las desigualdades educativas en los comportamientos de salud en Brasil entre 2013 y 2019

Considering the relevance of health behaviors for chronic diseases prevalence and mortality and the increase in income concentration observed in the world and in Brazil, this study aimed to evaluate the changes in the prevalence and in the educational inequalities of Brazilian adult health behaviors between 2013 and 2019. We analyzed data of 49,025 and 65,803 adults (18-59 years of age) from the Brazilian National Health Survey (PNS), 2013 and 2019. Prevalence of health behaviors (smoking, alcohol intake, diet, physical activity and sedentarism) were estimated for three educational strata, for both surveys. Prevalence ratios (PR) between year of survey and between educational strata were estimated by Poisson regression models. Significant reductions were found in the prevalence of smoking, physical inactivity, sedentarism, insufficient consumption of fruits, and the excessive consumption of sweetened beverages. However, an increase was observed in alcohol consumption and binge drinking; vegetable consumption remained stable. Contrasting the favorable change in some behaviors, inequalities among schooling strata remained very high in 2019, specially for smoking (PR = 2.82; 95%CI: 2.49-3.20), passive smoking (PR = 2.88; 95%CI: 2.56-3.23) and physical inactivity (PR = 2.02; 95%CI: 1.92-2.13). There was a significant increase in the educational inequality regarding physical inactivity (21%), insufficient intake of fruit (8%) and in the frequent consumption of sweetened beverages (32%). The persistence and enlargement of inequalities highlight the behaviors and social segments that should be special targets for policies and programs focused in promoting healthy lifestyles.

Dada a relevância dos comportamentos de saúde para a prevalência de doenças crônicas, a mortalidade devida a elas e o aumento da concentração de renda no mundo e no Brasil, este estudo procurou avaliar as mudanças na prevalência dos comportamentos de saúde e sua relação com desigualdades educacionais em adultos brasileiros entre 2013 e 2019. Foram analisados dados de 49.025 e 65.803 adultos (18-59 anos) em Pesquisa Nacional de Saúde (PNS), 2013 e 2019. A prevalência de comportamentos de saúde (tabagismo, ingestão de álcool, dieta, atividade física e sedentarismo) foi estimada para três estratos educacionais em ambas as PNS. As razões de prevalência (RP) entre os anos da pesquisa e os estratos educacionais foram estimadas pelos modelos de regressão de Poisson. Foram encontradas reduções expressivas na prevalência de tabagismo, inatividade física, sedentarismo, consumo insuficiente de frutas e ingestão excessiva de bebidas adoçadas. Observou-se um aumento no consumo de álcool (incluindo o excessivo), ao passo que o consumo de vegetais se manteve estável. Em contraste com a mudança favorável em alguns comportamentos, as desigualdades entre os estratos de escolaridade permaneceram muito altas em 2019, especialmente para tabagismo (RP = 2,82; IC95%: 2,49-3,20), fumo passivo (PR = 2,88; IC95%: 2,56-3,23) e inatividade física (RP = 2,02; IC95%: 1,92-2,13). Houve um aumento expressivo da desigualdade entre os estratos de escolaridade em relação à inatividade física (21%), à ingestão insuficiente de frutas (8%) e ao consumo frequente de bebidas adoçadas (32%). A persistência e o ampliação das desigualdades destacam os comportamentos e segmentos sociais que devem ser alvos especiais de políticas e programas focados na promoção de estilos de vida saudáveis.

Teniendo en cuenta la relevancia de los comportamientos de salud para la prevalencia de enfermedades crónicas, la mortalidad por ellas y el aumento de la concentración de la renta en el mundo y en Brasil, este estudio buscó evaluar los cambios en la prevalencia de comportamientos de salud y su relación con las desigualdades educativas en adultos brasileños en el periodo entre 2013 y 2019. Se analizaron 49.025 y 65.803 datos de adultos (18-59 años) de la Encuesta Nacional de Salud (PNS), 2013 y 2019. Se estimó la prevalencia de comportamientos de salud (tabaquismo, consumo de alcohol, dieta, actividad física y sedentarismo) para tres estratos educativos en ambas encuestas. Las razones de prevalencia (RP) entre el año de la encuesta y los estratos educativos se estimaron mediante modelos de regresión de Poisson. Se encontraron reducciones significativas en la prevalencia de tabaquismo, inactividad física, sedentarismo, consumo insuficiente de frutas y consumo excesivo de bebidas azucaradas. Se observó un mayor consumo de alcohol (incluido con exceso), mientras que el consumo de vegetales se mantuvo estable. En contraste con el cambio favorable en algunos comportamientos, las desigualdades entre estratos escolares se mantuvieron muy altas en 2019, especialmente para el tabaquismo (RP = 2,82; IC95%: 2,49-3,20), fumo passivo (RP = 2,88; IC95%: 2,56-3,23), y la inactividad física (RP = 2,02; IC95%: 1,92-2,13). Hubo un aumento significativo de la desigualdad en cuanto a la inactividad física (21%), la ingesta insuficiente de frutas (8%) y el consumo frecuente de bebidas azucaradas (32%). La persistencia y ampliación de las desigualdades ponen de manifiesto comportamientos y segmentos sociales que deben ser destinatarios especiales de políticas y programas orientadas hacia la promoción de estilos de vida saludables.

Incidence, mortality and survival of prostate cancer in two municipalities with a high human development index in Mato Grosso, Brazil / Incidência, mortalidade e sobrevida do câncer de próstata em dois municípios com alto índice de desenvolvimento humano de Mato Grosso, Brasil

ABSTRACT: Objective: To analyze the incidence, mortality and survival of prostate cancer in Cuiabá and Várzea Grande, Brazil from 2000 to 2016. Methods: Data from the Population-based Cancer Registry and the Mortality Information System were used. Mortality and incidence trends were analyzed using joinpoint regression models by age group. Survival analyses were performed using the Kaplan-Meier method, and hazard ratio was estimated by age group. Results: From 2000 to 2016, 3,671 new cases and 892 deaths for prostate cancer were recorded. The average incidence and mortality rates were 87.96 and 20.22 per 100,000, respectively. Decreasing incidence trend was noted for all age groups from 2006 to 2016 (APC=-3.2%) and for men with 80+ years of age from 2000 to 2016 (APC=-3.0%), and increasing mortality trend for men 60-69 years of age from 2000 to 2009 (APC=3.2%). The specific five-year survival rate for prostate cancer was 79.6% (95%CI 77.2-81.9), and the rate decreased with advanced age (HR=2.43, 95%CI 1.5-3.9, for those 70 to 79 years old and HR=7.20, 95%CI 4.5-11.5, for those 80 or older). Conclusion: The incidence rate of prostate cancer showed a decreasing trend from 2006 for all age groups; the mortality rate was stable in that period, and worse prognosis was observed in men 70 years or older.

RESUMO: Objetivo: Analisar a incidência, a mortalidade e a sobrevida por câncer de próstata em Cuiabá e Várzea Grande, no período de 2000 a 2016. Métodos: Foram utilizados os dados do Registro de Câncer de Base Populacional e do Sistema de Informações sobre Mortalidade. Para a análise de tendência da incidência e mortalidade, foi utilizada a regressão por Joinpoint segundo faixa etária. Para estimar a probabilidade de sobrevivência foi utilizado o método de Kaplan-Meier e, para avaliar a associação com a faixa etária, foi estimado o hazard ratio (HR). Resultados: De 2000 a 2016, registraram-se 3.671 casos novos e 892 óbitos por câncer de próstata. A média das taxas no período (100.000 habitantes) foi de 87,96 para incidência e 20,22 para mortalidade. Verificou-se tendência decrescente da taxa de incidência para todas as idades de 2006 a 2016 (variação percentual anual — APC=-3,2%) e para homens com 80 anos ou mais de 2000 a 2016 (APC=-3,0%), bem como tendência crescente da taxa de mortalidade nos homens de 60-69 anos de 2000 a 2009 (APC=3,2%). A probabilidade de sobrevida específica em cinco anos foi de 79,6% (intervalo de confiança — IC95%: 77,2; 81,9) e diminuiu com o aumento da faixa etária (HR=2,43; IC95%: 1,5; 3,9 para aqueles de 70 a 79 anos e HR= 7,20; IC95%: 4,5;11,5 para aqueles de 80 anos ou mais). Conclusão: A taxa de incidência de câncer de próstata apresentou tendência de decréscimo a partir de 2006 para todas as idades, a taxa de mortalidade foi estável no período e o pior prognóstico foi observado em homens com 70 anos ou mais.

Cancer surveillance in Mato Grosso, Brazil: methodological and operational aspects of a university extension/research project / Vigilância do câncer em Mato Grosso, Brasil: aspectos metodológicos e operacionais de um projeto de extensão/pesquisa

ABSTRACT: Objective: To describe the methodological and operational aspects of the "Project for surveillance of cancer and its associated factors: population-based and hospital-based registry" (VIGICAN), in the state of Mato Grosso (MT), Brazil. Methods: VIGICAN was divided into two projects: a university extension one, which updated the data from the Population-based Cancer Registry (PBCR) of MT in the 2008-2016 period; and a research project, which collected primary data, through individual interviews and analysis of medical records of people with a diagnosis of cancer, aged 18 years or older, treated at reference hospitals for oncology. To analyze the factors associated with cancer, the following variables were collected: socioeconomic and demographic, social support, health status and behavior, and environmental exposure. Results: In the 2008-2016 period, approximately one hundred thousand cases of cancer (incident and prevalent) were reported in the PBCR Cuiabá and PBCR Interior. After validation procedures, 50 thousand incident cases were elected. The survey interviewed 1,012 patients, 38.2% living in the municipalities of Cuiabá and Várzea Grande, 60.4% in small cities of the state, and 1.4% in other states. Preliminary data showed that the majority were women (55.0%) and younger than 60 years of age (54.3%). Among the interviewees, 7.2% reported smoking tobacco, 15.5% consumed alcoholic beverages (15.5%), and 32.7% lived nearby crops. Conclusion: The development of these projects allowed the integration of education with health services and will enable the recognition of specificities and different exposure scenarios and factors associated with cancer in the Mato Grosso territory.

RESUMO: Objetivo: Descrever os aspectos metodológicos e operacionais do projeto "Vigilância do câncer e seus fatores associados: registro de base populacional e hospitalar" (VIGICAN), em Mato Grosso (MT). Métodos: O VIGICAN desdobrou-se em dois projetos: um de extensão, que atualizou os dados dos Registros de Câncer de Base Populacional (RCBP) de Mato Grosso no período de 2008 a 2016; e um de pesquisa, que coletou dados primários por meio de entrevistas individuais e análise de prontuários de pessoas com diagnóstico de câncer, com 18 anos ou mais, atendidas em hospitais de referência para oncologia. Para analisar os fatores associados ao câncer, foram coletadas as seguintes variáveis: socioeconômicas e demográficas, suporte social, situação e comportamentos de saúde e exposição ambiental. Resultados: No período de 2008 a 2016, foram notificados nos RCBP Cuiabá e Interior, aproximadamente, 100 mil casos de câncer (incidentes e prevalentes). Após os procedimentos de validação, foram eleitos 50 mil casos incidentes. A pesquisa entrevistou 1.012 pacientes, sendo 38,2% residentes nos municípios de Cuiabá e Várzea Grande, 60,4% no interior do Estado e 1,4% em outros Estados. Os dados preliminares revelaram que a maioria era do sexo feminino (55,0%) e tinha menos de 60 anos (54,3%). Entre os entrevistados, 7,2% relataram fumar tabaco, 15,5% consumiam bebidas alcoólicas (15,5%) e 32,7% moravam próximo a lavouras. Conclusão: O desenvolvimento desses projetos permitiu a integração do ensino com os serviços de saúde e possibilitará o reconhecimento das especificidades e dos diferentes cenários de exposição ao câncer, bem como fatores associados a ele, no território mato-grossense.

Potential years of life lost to cancer in Mato Grosso, stratified by sex: 2000 to 2019 / Anos potenciais de vida perdidos por câncer em Mato Grosso, estratificados por sexo: 2000 a 2019

ABSTRACT: Objective: To estimate the potential years of life lost (PYLL) to cancer in the State of Mato Grosso, from 2000 to 2019, stratified by sex, according to age groups and cancer types. Methods: It is a quantitative study with an ecological approach developed from secondary data, using the PYLL and its derivatives. Results: In the period analyzed, deaths from cancer in Mato Grosso resulted in 680,338 PYLL before the age of 80, with a variation of 82.5%. Of this total, 52.7% were assigned to males. The rate of the PYLL for cancer before the age of 60 was 70.9% in males, and 80.1% among women. The rates of PYLL increased in the period and showed slightly higher values in males. In the analysis according to age group, the rates of PYLL were also higher in males, except between the ages of 30 and 49. Lung cancers and lymphomas/leukemias resulted in greater losses of PYLL among men and female specific cancers (breast, cervical and uterine, and ovarian cancer) accounted for 36.26% of the PYLL among women, with variability per age groups. Conclusion: In Mato Grosso, the PYLL indicator for cancer presented unfavorable evolution between 2000 and 2019, with greater damage for males and for the younger population. Leukemias, lymphomas, and lung and breast cancers were the main causes for the PYLL.

RESUMO: Objetivo: Estimar os anos potenciais de vida perdidos por câncer no estado de Mato Grosso, no período de 2000 a 2019, estratificando os dados por sexo, segundo faixas etárias e tipos de câncer. Métodos: Trata-se de um estudo quantitativo, com abordagem ecológica a partir de dados secundários, utilizando-se o indicador anos potenciais de vida perdidos e seus derivados. Resultados: No período analisado, as mortes por câncer em Mato Grosso resultaram em 680.338 anos potenciais de vida perdidos antes dos 80 anos, com variação de 82,5%. Desse total, 52,7% foram atribuídos ao sexo masculino. O peso dos anos potenciais de vida perdidos por câncer antes dos 60 anos foi de 70,9% no sexo masculino e 80,1% entre as mulheres. As taxas de anos potenciais de vida perdidos aumentaram no período estudado e apresentaram valores ligeiramente mais elevados entre os homens. Na análise segundo faixas etárias, as taxas de anos potenciais de vida perdidos também foram maiores entre os homens, exceto entre 30 e 49 anos. Os cânceres de pulmão e linfomas/leucemias resultaram em maiores perdas de anos potenciais de vida entre os homens, e os cânceres de especificidade feminina (mama, colo e corpo do útero e ovário) responderam por 36,26% dos anos potenciais de vida perdidos entre as mulheres, com variabilidade por faixas etárias. Conclusão: Em Mato Grosso, o indicador anos potenciais de vida perdidos por câncer apresentou evolução desfavorável entre 2000 e 2019, com maior prejuízo para o sexo masculino e para a população mais jovem. As leucemias, linfomas e cânceres de pulmão e mama foram os principais responsáveis pelos anos potenciais de vida perdidos.

Cancer mortality in the State of Mato Grosso from 2000 to 2015: temporal trend and regional differences / Mortalidade por câncer no estado de Mato Grosso, Brasil, no período de 2000 a 2015: tendência temporal e diferenças regionais

ABSTRACT: Objective: To analyze the trend of standardized cancer mortality rate in the state of Mato Grosso according to health regions, from 2000 to 2015. Methods: Ecological time series study with data on deaths by cancer from the Mortality Information System. The rates were standardized using direct method and calculated by year and health regions. The annual percentage changes (APC) and respective confidence interval (95%CI) were obtained through simple linear regression. Thematic maps were built to show the spatial distribution of rates. Results: There were 28,525 deaths by cancer registered in Mato Grosso, with the main types being lung, prostate, stomach, breast and liver cancer. The highest mortality rates were found in regions Médio Norte, Baixada Cuiabana and Sul Mato-Grossense. From 2000 to 2015, an upward trend was seen in the mortality rate by cancer in Mato Grosso (APC=0.81%; 95%CI 0.38-1.26), and in four health regions, Garças Araguaia (APC=2.27%; 95%CI 1.46-3.08), Sul Mato-Grossense (APC=1.12%; 95%CI 0.28-1.97), Teles Pires (APC=1.93%; 95%CI 0,11-3,74) and Vale dos Arinos (APC=2.61%; 95%CI 1.10-4.70), while the other regions remained stable. Conclusion: In the state of Mato Grosso and in the four health regions, cancer mortality rate showed a growing trend. The results point to the need to consider regional differences when thinking about actions for cancer prevention, control and assistance.

RESUMO: Objetivo: Analisar a tendência da taxa padronizada de mortalidade por câncer no estado de Mato Grosso, Brasil, conforme regiões de saúde, no período de 2000 a 2015. Métodos: Estudo ecológico de séries temporais com dados de óbitos por neoplasias do Sistema de Informação sobre Mortalidade. As taxas foram padronizadas pelo método direto e calculadas por ano e por regiões de saúde. A variação anual percentual (annual percent change — APC) e seu respectivo intervalo de 95% de confiança (IC95%) foram obtidos por meio da regressão linear simples. Construíram-se mapas temáticos para descrever a distribuição espacial das taxas. Resultados: Foram registrados 28.525 óbitos por câncer em Mato Grosso, e os cinco principais tipos de câncer foram de pulmão, próstata, estômago, mama e fígado. As maiores taxas de mortalidade foram encontradas nas regiões Médio Norte, Baixada Cuiabana e Sul-Mato-Grossense. No período de 2000 a 2015 foi observada tendência crescente na taxa de mortalidade por câncer em Mato Grosso (APC=0,81%; IC95% 0,38-1,26), e em quatro regiões de saúde, Garças Araguaia (APC=2,27%; IC95% 1,46-3,08), Sul-Mato-Grossense (APC=1,12%; IC95% 0,28-1,97), Teles Pires (APC=1,93%; IC95% 0,11-3,74) e Vale dos Arinos (APC=2,61%; IC95% 1,10-4,70). As demais regiões apresentaram estabilidade. Conclusão: No estado de Mato Grosso e em quatro regiões de saúde foi verificada tendência crescente de mortalidade por câncer. Os resultados indicam a necessidade de se considerar as diferenças regionais para as ações de prevenção e assistência ao câncer e de controle.

Association between health behaviors and depression: findings from the 2019 Brazilian National Health Survey.

OBJECTIVE: To analyze the association of depression with various health behaviors and to verify if they differ according to gender or income. METHODS: This is a cross-sectional study based on data of 65,803 Brazilian adults (18-59 years old) interviewed in the National Health Survey, conducted in 2019. Presence or absence of depression was evaluated using the Patient Health Questionnaire (PHQ)-9. The prevalence of smoking, alcohol consumption, physical activity, sedentary lifestyle and food indicators were estimated according to the presence of depression. Stratified analyses were made according to sex and income, and prevalence ratios were estimated using the Poisson Regression. RESULTS: We found a significant association between depression and all indicators studied, except occasional alcohol consumption. Depression was associated with heavy episodic drinking and insufficient consumption of fruits and vegetables only in women. In men, the associations of depression with sedentary lifestyle and with being a former smoker were stronger than in women. The occasional consumption of alcohol was more prevalent only in men without depression. The analysis stratified by income showed that the association of depression with physical inactivity is stronger in the higher-income group, while with heavy episodic drinking is only significant in the lower-income stratum. CONCLUSION: The results point to the need to consider mental health in programs aimed at reducing harmful health behaviors and the specificity of sociodemographic groups.

Association of major depressive disorder with chronic diseases and multimorbidity in Brazilian adults, stratified by gender: 2019 National Health Survey.

OBJECTIVE: To analyze the association of major depressive disorder with chronic non-communicable diseases and multimorbidity in Brazilian adults, stratified by gender, as well as examine the interaction between gender and chronic non-communicable diseases in association with major depressive disorder. METHODS: Based on a sample of 65,803 adults from the 2019 National Health Survey, we estimated the prevalence of major depressive disorder (≥10 points in the Patient Health Questionnaire) according to the presence of chronic non-communicable diseases and multimorbidity (≥2 chronic diseases). Prevalence ratios and their respective confidence intervals were calculated by Poisson regression, and multiplicative interaction terms were used to assess the role of gender in the associations. RESULTS: The prevalence of major depressive disorder among Brazilian adults (18-59 years) was 10.9%, with a statistically significant difference between men (6.0%) and women (15.4%) (p<0.001). Individuals with any chronic non-communicable disease and multimorbidity showed a higher prevalence of major depressive disorder, both in the general population and in each gender. However, the association of major depressive disorder with chronic non-communicable diseases tended to be stronger among men. Data also showed an interaction between the male gender and multimorbidity or specific diseases, such as arthritis or rheumatism, heart disease, and chronic kidney disease, in association with major depressive disorder. CONCLUSION: The results reveal a significant association between major depressive disorder and chronic non-communicable diseases in both genders and raise the hypothesis that the effects of multimorbidity and certain diseases may be greater on the mental health of men.

Social inequalities in indicators of active aging: a population-based study. / Desigualdades sociais em indicadores de envelhecimento ativo: estudo de base populacional.

The objective of this study was to analyze inequalities in active aging indicators according to race/skin color, level of education, income, and possession of health insurance among 986 older people who participated in the 2014/15 Campinas Health Survey. We estimated the prevalence of participation in 11 activity domains using Poisson regression. The findings reveal similar levels of participation among white and black people in all the domains of the social dimension. The prevalence of work-related physical activity was higher among black people (14.1% compared to 8.2% in white people) and the prevalence of internet use was higher among white people (PR = 2.11). The prevalence of participation in leisure time physical activity, internet use, courses, and in all domains of the social dimension except attendance at religious services was higher among respondents in the highest educational and income groups and among those with health insurance. The findings reveal that older people with a higher income and higher level of education are more likely to participate in activities associated with better health and well-being. The study also shows that older people place a significant demand on Brazil's public health system since individuals who depend exclusively on public health services tend to participate less in activities that are shown to promote health benefits.

O objetivo deste estudo foi analisar desigualdades em indicadores de envelhecimento ativo, segundo raça/cor, escolaridade, renda e posse de plano de saúde entre 986 idosos participantes do Inquérito de Saúde de Campinas, São Paulo - 2014/2015. Estimaram-se as prevalências de participação dos idosos em 11 atividades e as razões de prevalência foram calculadas pela regressão de Poisson. Os resultados revelaram que brancos e negros participavam de forma semelhante de todas as atividades da dimensão social, porém na atividade física realizada no trabalho se observou predomínio de negros (14,1% versus 8,2%), e no uso da Internet se constatou maior prevalência de brancos (RP = 2,11). Entre os idosos com maior escolaridade, renda mais elevada e posse de plano de saúde foram observadas maiores prevalências de participação em atividades físicas de lazer, uso da Internet, realização de cursos e atividades sociais, exceto cultos religiosos. Os resultados revelam que os idosos com maior acúmulo de recursos educacionais e financeiros têm mais acesso às atividades que são reconhecidamente associadas à saúde e ao bem-estar. O estudo também identificou importantes demandas para o SUS, pois a população que depende exclusivamente desse sistema apresentou menor participação em atividades benéficas à saúde.

Desigualdades sociais em indicadores de envelhecimento ativo: estudo de base populacional / Social inequalities in indicators of active aging: a population-based study

Resumo O objetivo deste estudo foi analisar desigualdades em indicadores de envelhecimento ativo, segundo raça/cor, escolaridade, renda e posse de plano de saúde entre 986 idosos participantes do Inquérito de Saúde de Campinas, São Paulo - 2014/2015. Estimaram-se as prevalências de participação dos idosos em 11 atividades e as razões de prevalência foram calculadas pela regressão de Poisson. Os resultados revelaram que brancos e negros participavam de forma semelhante de todas as atividades da dimensão social, porém na atividade física realizada no trabalho se observou predomínio de negros (14,1% versus 8,2%), e no uso da Internet se constatou maior prevalência de brancos (RP = 2,11). Entre os idosos com maior escolaridade, renda mais elevada e posse de plano de saúde foram observadas maiores prevalências de participação em atividades físicas de lazer, uso da Internet, realização de cursos e atividades sociais, exceto cultos religiosos. Os resultados revelam que os idosos com maior acúmulo de recursos educacionais e financeiros têm mais acesso às atividades que são reconhecidamente associadas à saúde e ao bem-estar. O estudo também identificou importantes demandas para o SUS, pois a população que depende exclusivamente desse sistema apresentou menor participação em atividades benéficas à saúde.

Abstract The objective of this study was to analyze inequalities in active aging indicators according to race/skin color, level of education, income, and possession of health insurance among 986 older people who participated in the 2014/15 Campinas Health Survey. We estimated the prevalence of participation in 11 activity domains using Poisson regression. The findings reveal similar levels of participation among white and black people in all the domains of the social dimension. The prevalence of work-related physical activity was higher among black people (14.1% compared to 8.2% in white people) and the prevalence of internet use was higher among white people (PR = 2.11). The prevalence of participation in leisure time physical activity, internet use, courses, and in all domains of the social dimension except attendance at religious services was higher among respondents in the highest educational and income groups and among those with health insurance. The findings reveal that older people with a higher income and higher level of education are more likely to participate in activities associated with better health and well-being. The study also shows that older people place a significant demand on Brazil's public health system since individuals who depend exclusively on public health services tend to participate less in activities that are shown to promote health benefits.

Association of major depressive disorder with chronic diseases and multimorbidity in Brazilian adults, stratified by gender: 2019 National Health Survey / Associação do transtorno depressivo maior com doenças crônicas e multimorbidade em adultos brasileiros, estratificada por sexo: Pesquisa Nacional de Saúde 2019

ABSTRACT: Objective: To analyze the association of major depressive disorder with chronic non-communicable diseases and multimorbidity in Brazilian adults, stratified by gender, as well as examine the interaction between gender and chronic non-communicable diseases in association with major depressive disorder. Methods: Based on a sample of 65,803 adults from the 2019 National Health Survey, we estimated the prevalence of major depressive disorder (≥10 points in the Patient Health Questionnaire) according to the presence of chronic non-communicable diseases and multimorbidity (≥2 chronic diseases). Prevalence ratios and their respective confidence intervals were calculated by Poisson regression, and multiplicative interaction terms were used to assess the role of gender in the associations. Results: The prevalence of major depressive disorder among Brazilian adults (18-59 years) was 10.9%, with a statistically significant difference between men (6.0%) and women (15.4%) (p<0.001). Individuals with any chronic non-communicable disease and multimorbidity showed a higher prevalence of major depressive disorder, both in the general population and in each gender. However, the association of major depressive disorder with chronic non-communicable diseases tended to be stronger among men. Data also showed an interaction between the male gender and multimorbidity or specific diseases, such as arthritis or rheumatism, heart disease, and chronic kidney disease, in association with major depressive disorder. Conclusion: The results reveal a significant association between major depressive disorder and chronic non-communicable diseases in both genders and raise the hypothesis that the effects of multimorbidity and certain diseases may be greater on the mental health of men.

RESUMO: Objetivo: Analisar a associação do transtorno depressivo maior com a presença de doenças crônicas não transmissíveis e multimorbidade em adultos brasileiros, estratificada por sexo, e examinar a interação entre sexo e doenças crônicas não transmissíveis na associação com o transtorno depressivo maior. Métodos: Com base em amostra de 65.803 adultos da Pesquisa Nacional de Saúde de 2019 foram estimadas as prevalências de transtorno depressivo maior (≥10 pontos do instrumento Patient Health Questionnaire) segundo a presença de doenças crônicas não transmissíveis e multimorbidade (≥2 doenças crônicas). As razões de prevalência e os respectivos intervalos de confiança foram estimados por meio da regressão de Poisson, e os termos de interação multiplicativa foram utilizados para avaliar o papel do sexo nas associações. Resultados: A prevalência de transtorno depressivo maior entre adultos brasileiros (18-59 anos) foi estimada em 10,9%, com diferença estatisticamente significante entre homens (6,0%) e mulheres (15,4%) (p<0,001). Entre os indivíduos com quaisquer doenças crônicas não transmissíveis e multimorbidade foram observadas prevalências mais elevadas de transtorno depressivo maior, tanto na população geral como em cada sexo. Entretanto, a associação do transtorno depressivo maior com as doenças crônicas não transmissíveis tendeu a ser mais forte entre os homens. Os dados também mostraram interação entre sexo masculino e multimorbidade ou doenças específicas como artrite ou reumatismo, doença cardíaca e insuficiência renal crônica na associação com o transtorno depressivo maior. Conclusão: Os resultados revelam expressiva associação entre transtorno depressivo maior e doenças crônicas não transmissíveis, em ambos os sexos, e levantam a hipótese de que o efeito da multimorbidade e de certas doenças pode ser maior na saúde mental dos homens.

Association between health behaviors and depression: findings from the 2019 Brazilian National Health Survey / Associação entre comportamentos de saúde e depressão: resultados da Pesquisa Nacional de Saúde de 2019

ABSTRACT Objective: To analyze the association of depression with various health behaviors and to verify if they differ according to gender or income. Methods: This is a cross-sectional study based on data of 65,803 Brazilian adults (18-59 years old) interviewed in the National Health Survey, conducted in 2019. Presence or absence of depression was evaluated using the Patient Health Questionnaire (PHQ)-9. The prevalence of smoking, alcohol consumption, physical activity, sedentary lifestyle and food indicators were estimated according to the presence of depression. Stratified analyses were made according to sex and income, and prevalence ratios were estimated using the Poisson Regression. Results: We found a significant association between depression and all indicators studied, except occasional alcohol consumption. Depression was associated with heavy episodic drinking and insufficient consumption of fruits and vegetables only in women. In men, the associations of depression with sedentary lifestyle and with being a former smoker were stronger than in women. The occasional consumption of alcohol was more prevalent only in men without depression. The analysis stratified by income showed that the association of depression with physical inactivity is stronger in the higher-income group, while with heavy episodic drinking is only significant in the lower-income stratum. Conclusion: The results point to the need to consider mental health in programs aimed at reducing harmful health behaviors and the specificity of sociodemographic groups.

RESUMO: Objetivo: Analisar a associação da depressão com comportamentos de saúde e verificar se as associações diferem segundo sexo e renda. Métodos: Estudo transversal com dados de 65.803 adultos brasileiros (18-59 anos) da Pesquisa Nacional de Saúde realizada em 2019. A presença de depressão foi avaliada com o uso do Patient Health Questionnaire-9 (PHQ-9). As prevalências de tabagismo, consumo de álcool, atividade física, sedentarismo e indicadores de alimentação foram estimadas segundo a presença de depressão. Foram desenvolvidas análises estratificadas por sexo e renda e estimadas as razões de prevalência com a regressão de Poisson. Resultados: Verificou-se associação significativa da depressão com todos os indicadores estudados, exceto com o consumo eventual de álcool. Apenas nas mulheres a depressão se mostrou associada com heavy episodic drinking e com o consumo insuficiente de frutas, legumes e verduras. Nos homens, as razões de prevalência das associações de depressão com sedentarismo e com ser ex-fumante foram mais elevadas de que nas mulheres e apenas nos homens o consumo eventual de álcool foi mais prevalente naqueles sem depressão. A análise estratificada segundo a renda mostrou que a associação da depressão com a inatividade física foi mais forte no segmento de renda superior e a associação com heavy episodic drinking só foi significativa no estrato de renda inferior. Conclusão: Os resultados apontam a necessidade de considerar a saúde mental nos programas que visam à redução de comportamentos nocivos à saúde e também de levar em conta as especificidades dessas associações nos diferentes estratos sociodemográficos.

Income inequality and functional capacity of the elderly in a city in Southeastern Brazil. / Desigualdades de renda e capacidade funcional de idosos em município do Sudeste brasileiro.

OBJECTIVE: Estimate the magnitude of the income inequality in the prevalence of functional dependency for basic and instrumental activities of daily life (BADLs, IADLs) and the abandonment of advanced activities (AADLs). METHODS: This was a cross-sectional, population-based study, developed using sample data of 986 elderly people from a health survey carried out in the municipality of Campinas, São Paulo, in 2014/15. The prevalence of functional dependency in BADLs and IADLs and of abandonment of the AADLs was estimated according to monthly family income per capita. A multiple regression Poisson analysis was developed to estimate the prevalence ratio (PR) adjusted by gender and age. RESULTS: There was no significant association between income and functional dependency for BADLs. Of the seven IADLs analyzed, five presented a higher prevalence of dependency in the lower-income stratum, with special highlight to using the phone (PR = 3.50), controlling medication usage (PR = 2.44), and use of transportation (PR = 2.35). The abandonment of AADLs was higher among low-income elderly people in all activities analyzed, with the greatest inequalities observed in making contact by letter, phone and e-mail (PR = 3.76), using the Internet (PR = 3.34), driving vehicles (PR = 2.85) and visiting family (PR = 2.77). CONCLUSIONS: The broad inequality detected among income stratum regarding the functional capability for the IADLs and abandonment of the AADLs emphasize the importance of fully implementing and maintaining the policies and programs directed toward the social protection of elderly adults. The focus should be on the most socially vulnerable segments, with the aim of achieving a population that is more equal, active, independent, and involved in participatory ageing.

OBJETIVO: Estimar a magnitude das desigualdades de renda nas prevalências de dependência funcional em atividades básicas e instrumentais da vida diária (ABVDs e AIVDs, respectivamente) e no abandono de atividades avançadas (AAVDs). MÉTODOS: Estudo transversal, de base populacional, desenvolvido com dados de amostra de 986 idosos de inquérito de saúde realizado no município de Campinas, São Paulo, em 2014/15. Foram estimadas as prevalências de dependência funcional em ABVDs e AIVDs e de abandono das AAVDs segundo a renda familiar mensal per capita, bem como desenvolvidas análises de regressão múltipla de Poisson para estimar razões de prevalência (RPs) ajustadas por sexo e idade. RESULTADOS: Não houve associação significativa entre renda e dependência funcional em ABVDs. Das sete AIVDs analisadas, cinco apresentaram maior prevalência de dependência no estrato de menor renda, com destaque para o uso de telefone (RP = 3,50), o controle do uso de remédios (RP = 2,40) e o uso de transporte (RP = 2,35). O abandono de AAVDs foi maior entre os idosos de menor renda em todas as atividades analisadas, com maiores desigualdades observadas no contato por carta, telefone e e-mail (RP = 3,76), no uso de internet (RP = 3,34), em dirigir veículos (RP = 2,85) e na visita a familiares (RP = 2,77). CONCLUSÃO: As amplas desigualdades detectadas entre estratos de renda quanto à capacidade funcional nas AIVDs e no abandono das AAVDs ressaltam a importância da plena implementação e manutenção de políticas e programas voltados à proteção social de idosos, focando, em especial, os segmentos socialmente mais vulneráveis, na perspectiva de se atingir um patamar populacional mais equânime de um envelhecimento ativo, participativo e independente.

Desigualdades de renda e capacidade funcional de idosos em município do Sudeste brasileiro / Income inequality and functional capacity of the elderly in a city in Southeastern Brazil

RESUMO: Objetivo: Estimar a magnitude das desigualdades de renda nas prevalências de dependência funcional em atividades básicas e instrumentais da vida diária (ABVDs e AIVDs, respectivamente) e no abandono de atividades avançadas (AAVDs). Métodos: Estudo transversal, de base populacional, desenvolvido com dados de amostra de 986 idosos de inquérito de saúde realizado no município de Campinas, São Paulo, em 2014/15. Foram estimadas as prevalências de dependência funcional em ABVDs e AIVDs e de abandono das AAVDs segundo a renda familiar mensal per capita, bem como desenvolvidas análises de regressão múltipla de Poisson para estimar razões de prevalência (RPs) ajustadas por sexo e idade. Resultados: Não houve associação significativa entre renda e dependência funcional em ABVDs. Das sete AIVDs analisadas, cinco apresentaram maior prevalência de dependência no estrato de menor renda, com destaque para o uso de telefone (RP = 3,50), o controle do uso de remédios (RP = 2,40) e o uso de transporte (RP = 2,35). O abandono de AAVDs foi maior entre os idosos de menor renda em todas as atividades analisadas, com maiores desigualdades observadas no contato por carta, telefone e e-mail (RP = 3,76), no uso de internet (RP = 3,34), em dirigir veículos (RP = 2,85) e na visita a familiares (RP = 2,77). Conclusão: As amplas desigualdades detectadas entre estratos de renda quanto à capacidade funcional nas AIVDs e no abandono das AAVDs ressaltam a importância da plena implementação e manutenção de políticas e programas voltados à proteção social de idosos, focando, em especial, os segmentos socialmente mais vulneráveis, na perspectiva de se atingir um patamar populacional mais equânime de um envelhecimento ativo, participativo e independente.

ABSTRACT: Objective: Estimate the magnitude of the income inequality in the prevalence of functional dependency for basic and instrumental activities of daily life (BADLs, IADLs) and the abandonment of advanced activities (AADLs). Methods: This was a cross-sectional, population-based study, developed using sample data of 986 elderly people from a health survey carried out in the municipality of Campinas, São Paulo, in 2014/15. The prevalence of functional dependency in BADLs and IADLs and of abandonment of the AADLs was estimated according to monthly family income per capita. A multiple regression Poisson analysis was developed to estimate the prevalence ratio (PR) adjusted by gender and age. Results: There was no significant association between income and functional dependency for BADLs. Of the seven IADLs analyzed, five presented a higher prevalence of dependency in the lower-income stratum, with special highlight to using the phone (PR = 3.50), controlling medication usage (PR = 2.44), and use of transportation (PR = 2.35). The abandonment of AADLs was higher among low-income elderly people in all activities analyzed, with the greatest inequalities observed in making contact by letter, phone and e-mail (PR = 3.76), using the Internet (PR = 3.34), driving vehicles (PR = 2.85) and visiting family (PR = 2.77). Conclusions: The broad inequality detected among income stratum regarding the functional capability for the IADLs and abandonment of the AADLs emphasize the importance of fully implementing and maintaining the policies and programs directed toward the social protection of elderly adults. The focus should be on the most socially vulnerable segments, with the aim of achieving a population that is more equal, active, independent, and involved in participatory ageing.

Social inequalities in the food consumption profile of the Brazilian population: National Health Survey, 2013. / Desigualdades sociais no perfil de consumo de alimentos da população brasileira: Pesquisa Nacional de Saúde, 2013.

INTRODUCTION: High income concentration prevails in Brazil and socioeconomic status influences living and health conditions, including dietary quality. OBJECTIVE: To measure the magnitude of social inequalities in the food quality profile of the Brazilian population. METHOD: We analyzed data from 60,202 adults who participated in the 2013 National Health Survey. The prevalence of indicators of food quality was estimated according to gender, ethnicity, income, schooling, and health insurance. We calculated prevalence ratios using multiple Poisson regression. RESULTS: Healthy food consumption was more prevalent among females, white people, and individuals with higher socioeconomic status. However, we also found a higher prevalence of some foods considered unhealthy, such as sweets, sandwiches, snacks, and pizzas, among the most favored social segments, in women, and white people, expressing the concomitance of healthy and unhealthy eating habits. The comparison between the consumption of skim and low-fat milk according to income (prevalence ratio - PR = 4.48) presented the most significant difference. CONCLUSION: In addition to the expressive social inequality identified in the Brazilian food profile, mixed patterns were detected, including healthy and unhealthy foods. These results point out the need for monitoring and promoting healthy eating habits, taking into account the social inequalities and contradictions concerning food intake.

INTRODUÇÃO: É amplamente reconhecido que elevada concentração de renda prevalece no Brasil e que a posição socioeconômica dos segmentos sociais exerce influência nas condições de vida e saúde, incluindo a qualidade da alimentação. OBJETIVO: Medir a magnitude das desigualdades sociais no perfil da qualidade alimentar da população brasileira. MÉTODO: Analisaram-se dados da amostra de 60.202 adultos da Pesquisa Nacional de Saúde de 2013. Foram estimadas as prevalências de indicadores de qualidade alimentar segundo sexo, raça/cor, renda, escolaridade e posse de plano de saúde. Razões de prevalência foram estimadas por meio de regressão múltipla de Poisson. RESULTADOS: Maior prevalência de consumo de alimentos saudáveis foi verificada no sexo feminino, entre os brancos e no grupo de melhor nível socioeconômico. Entretanto,para alguns alimentos considerados não saudáveis, como doces, sanduíches, salgados e pizzas, também foi observada maior prevalência nos segmentos sociais mais favorecidos, nas mulheres e nos brancos, expressando a concomitância de escolhas alimentares saudáveis e não saudáveis. Desigualdade de maior magnitude foi observada quanto à comparação do consumo de leite desnatado e semidesnatado segundo renda (razão de prevalência - RP=4,48). CONCLUSÃO: Além de expressiva desigualdade social no perfil alimentar dos brasileiros, foram detectados perfis mistos, incluindo alimentos saudáveis e não saudáveis, sinalizando a necessidade de monitoramento e de intervenções de promoção de alimentação saudável que levem em conta as desigualdades sociais e as contradições no consumo alimentar.

Social inequalities in the prevalence of indicators of active aging in the Brazilian population: National Health Survey, 2013. / Desigualdades sociais na prevalência de indicadores de envelhecimento ativo na população brasileira: Pesquisa Nacional de Saúde, 2013.

OBJECTIVE: To analyze social inequalities in the prevalence of indicators of active aging in the Brazilian older adult population. METHODS: This is a cross-sectional study with a sample of 11,177 older adults who participated in the Brazilian National Health Survey in 2013. We estimated the prevalence of five domains of active aging (social activities, civic engagement, leisure-time physical activity, paid work, and volunteer work) according to gender, ethnicity, schooling, income, and private health insurance. Prevalence ratios and confidence intervals were calculated using Poisson regression. RESULTS: The percentage of involvement in organized social activities, civic engagement, and physical activity was 25.1, 12.4, and 13.1%, respectively. Regarding work, 20.7% of the sample had a paid job, and 9.7% participated in volunteer work. Women had a higher prevalence of participation in organized social activities and volunteer work; while civic engagement and paid work were more frequent among men. White people were more likely to participate in social activities, volunteer work, and leisure-time physical activity, explained by their schooling. The strata with a higher level of schooling, income, and who had private health insurance showed a greater incidence of participation in all activities studied. CONCLUSION: The five activities analyzed are challenging for the proposed policy of active aging, as they are marked by considerable social inequality.

OBJETIVO: Analisar desigualdades sociais na prevalência de indicadores de envelhecimento ativo na população idosa brasileira. MÉTODOS: Estudo transversal com amostra de 11.177 idosos que participaram da Pesquisa Nacional de Saúde do Brasil em 2013. Estimaram-se as prevalências de cinco domínios do envelhecimento ativo (atividades sociais, participação cívica, atividade física de lazer, trabalho remunerado e trabalho voluntário) segundo sexo, raça/cor, escolaridade, renda e posse de plano privado de saúde. As razões de prevalência e os intervalos de confiança foram calculados pela regressão de Poisson. RESULTADOS: O percentual de envolvimento em atividades sociais organizadas, participação cívica e atividade física foi de 25,1; 12,4 e 13,1%, respectivamente. Em relação ao trabalho, 20,7% exerciam trabalho remunerado e 9,7% participavam de trabalho voluntário. As mulheres apresentaram maiores prevalências de participação em atividades sociais organizadas e em trabalho voluntário; e entre os homens prevaleceu a participação cívica e o trabalho remunerado. Entre os brancos, foram observadas maiores frequências de participação em atividades sociais, trabalho voluntário e atividade física de lazer, explicadas pela escolaridade. E os estratos com maior nível de escolaridade, renda e com posse de plano privado de saúde apresentaram maiores prevalências de participação em todas as atividades consideradas. CONCLUSÃO: As cinco atividades analisadas se apresentam como desafiadoras à proposta política de envelhecimento ativo por serem marcadas por considerável desigualdade social.