Sex differences in the impact of musculoskeletal disorders on health-related quality of life: a population-based study, Campinas, SP - ISACamp 2014/15.

This article aims to estimate the prevalence of musculoskeletal disorders (MD) on the adult population of Campinas, São Paulo, Brazil, verifying associated demographic and socioeconomic factors, and to analyze their impact on Health-Related Quality of Life (HRQoL) according to sex. A population-based study was conducted with 2,166 individuals using data from the ISACamp 2014/15. The Medical Outcomes Study SF-36-Item Short Form Health Survey (SF-36) was used to measure HRQoL according to MD. Prevalence ratios (PR) were estimated by Poisson regression. Musculoskeletal disorders had a prevalence of 8.5% (6.7% tendonitis and 2.7% work-related musculoskeletal disorders - WMSD). Results showed a higher prevalence of musculoskeletal disorders in women, active or on leave due to illness, and in individuals with higher education levels. Moreover, reduced HRQoL scores were observed in 6 of the 8 domains, due to MD. The mental component and physical component showed greater impairment respectively among women and men after self-reported WMSD. These findings point to substantial damage from musculoskeletal disorders on the population's HRQoL. WMSD affect the HRQoL of men and women distinctly.

Sex differences in the impact of musculoskeletal disorders on health-related quality of life: a population-based study, Campinas, SP - ISACamp 2014/15 / Diferenças entre os sexos no impacto das doenças musculoesqueléticas na qualidade de vida relacionada à saúde: estudo de base populacional, Campinas, SP - ISACamp 2014/15

Abstract This article aims to estimate the prevalence of musculoskeletal disorders (MD) on the adult population of Campinas, São Paulo, Brazil, verifying associated demographic and socioeconomic factors, and to analyze their impact on Health-Related Quality of Life (HRQoL) according to sex. A population-based study was conducted with 2,166 individuals using data from the ISACamp 2014/15. The Medical Outcomes Study SF-36-Item Short Form Health Survey (SF-36) was used to measure HRQoL according to MD. Prevalence ratios (PR) were estimated by Poisson regression. Musculoskeletal disorders had a prevalence of 8.5% (6.7% tendonitis and 2.7% work-related musculoskeletal disorders - WMSD). Results showed a higher prevalence of musculoskeletal disorders in women, active or on leave due to illness, and in individuals with higher education levels. Moreover, reduced HRQoL scores were observed in 6 of the 8 domains, due to MD. The mental component and physical component showed greater impairment respectively among women and men after self-reported WMSD. These findings point to substantial damage from musculoskeletal disorders on the population's HRQoL. WMSD affect the HRQoL of men and women distinctly.

Resumo O objetivo deste artigo é estimar a prevalência de doenças musculoesqueléticas (DM) na população adulta de Campinas/SP, Brasil, verificar fatores demográficos e socioeconômicos associados e analisar o seu impacto na qualidade de vida relacionada à saúde (QVRS) segundo sexo. Este é um estudo de base populacional utilizando dados do ISACamp 2014/15, com 2.166 indivíduos. Para a medida de QVRS, foram calculados os escores médios do Short Form Health Survey 36 (SF-36) segundo as DM e utilizada a regressão de Poisson para estimar as razões de prevalência (RP). A prevalência de DM foi de 8,5% (6,7% de tendinite e 2,7% de doenças osteomusculares relacionadas ao trabalho - DORT). Os resultados deste estudo mostraram maior prevalência de DM em mulheres, na população adulta ativa ou afastada por doença e em indivíduos com maior escolaridade. Além disso, observou-se redução nos escores de QVRS, devido às DM, em quase todos os domínios do instrumento. O maior comprometimento foi observado no componente mental entre as mulheres, e no componente físico, entre os homens, após autorrelato de DORT. Os achados mostram o impacto substancial das DM na QVRS da população. As DORT afetam distintamente a QVRS de homens e mulheres.

Smoking among Brazilian adolescents during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: The social distancing measures during the coronavirus disease 2019 (COVID-19) pandemic resulted in mental suffering among adolescents, leading to risky consumption of psychoactive substances such as tobacco. OBJECTIVE: To analyze the factors associated with tobacco use among adolescents during the COVID-19 social distancing period in Brazil. DESIGN AND SETTING: Cross-sectional study used data from ConVid Adolescentes survey in Brazil. METHODS: Tobacco use was assessed before and during social distancing. The explanatory variables investigated were sex, age, race/skin color, type of school, maternal education, region of residence, adherence to social restriction measures, number of close friends, sleep quality during the pandemic, mood, passive smoking, use of alcoholic beverages during the pandemic, sedentary behavior, and physical activity. A logistic regression model was used for the data analysis. RESULTS: Tobacco use by adolescents did not change during the pandemic (from 2.58% to 2.41%). There was a higher chance of tobacco use among adolescents aged between 16 and 17 years, self-reported black ones, residing in the South and Southeast regions, reported feeling sad and loneliness, had sleeping problems that worsened, were using alcoholic beverages during the pandemic, and were passive smokers at home. Adolescents whose mothers had completed high school or higher, had strict social restrictions, and increased their physical activity during the pandemic had a lower chance of tobacco use. CONCLUSION: Tobacco uses during the COVID-19 pandemic was higher in vulnerable groups, such as black adolescents and those with mental suffering.

Chronic diseases and health conditions in adolescents: Sex inequalities. / Doenças crônicas e problemas de saúde de adolescentes: desigualdades segundo sexo.

OBJECTIVE: To estimate the prevalence of chronic diseases and health conditions in adolescents from Campinas (São Paulo), investigating sex differences according to age group. METHODS: This population-based study analyzed data from the ISACamp 2014/15 health survey, with a total of 1,022 adolescents interviewed. The interviewees consisted of 517 boys and 505 girls; 492 of them in the ten to 14 age group and 530 in the 15 to 19 age group. We verified the associations using the χ2 test with Rao Scott adjustment and estimated prevalence ratios (PR) with multiple Poisson regression adjusted for age. Analyses were also stratified by age group. RESULTS: Respiratory diseases, such as rhinitis (25.3%), sinusitis (15.7%), and asthma (10.9%), were the most prevalent among adolescents. Health complaints were high, especially headaches (39.5%), emotional conditions (34.5%), allergies (27.5%), and back pain (21.3%). More than 22.0% of adolescents reported having three or more health conditions. Girls declared a higher number of health conditions (three or more) than boys (PR=2.27). CONCLUSION: The study showed that adolescents presented a significant number of health conditions, particularly regarding complaints, indicating the need for clinical care and public policies aimed at controlling and preventing these diseases in this age group.

OBJETIVO: Estimar as prevalências de doenças crônicas e problemas de saúde em adolescentes de Campinas (SP), observando as diferenças entre os sexos, por faixa etária. MÉTODOS: Estudo em base populacional, com dados do inquérito de saúde ISACamp de 2014/15, cujas entrevistas com adolescentes totalizaram 1.022. Desses entrevistados, 517 eram meninos e 505, meninas; 492 encontravam-se na faixa de dez a 14 anos e 530 tinham entre 15 e 19 anos. As associações foram verificadas por meio do teste de χ² com ajuste de Rao Scott, e as razões de prevalência (RP) foram estimadas por meio de regressão múltipla de Poisson ajustadas por idade. Também foram feitas análises estratificadas por faixa etária. RESULTADOS: As doenças respiratórias foram as mais prevalentes nos adolescentes como rinite (25,3%), sinusite (15,7%) e asma (10,9%). As queixas de saúde apresentaram-se elevadas, destacando-se as dores de cabeça (39,5%), problemas emocionais (34,5%), alergias (27,5%) e dores nas costas (21,3%). O número de adolescentes que apontaram ter três ou mais problemas de saúde mostrou-se acima de 22,0%. As meninas referiram maior número de problemas de saúde (três ou mais) do que os meninos (RP=2,27). CONCLUSÃO: O estudo demonstrou que os adolescentes apresentaram número expressivo de problemas de saúde, principalmente em relação às queixas, sinalizando que são necessários cuidados clínicos e políticas públicas direcionadas para o controle e prevenção desses agravos nesta faixa etária.

Health behaviors and multimorbidity associated with bruxism: Population-based study.

OBJECTIVES: Determine the prevalence of possible bruxism in the adult population of Campinas, Brazil, and investigate its association with health behaviors, health status, and multimorbidity. METHODS: A population-based cross-sectional study was conducted with data from the 2014/2015 Campinas Health Survey. The sample was composed of 1986 adults (≥20 years of age). The data were collected with the aid of a pre-coded questionnaire, and the dependent variable was self-reported bruxism (possible bruxism). The prevalence of possible bruxism was estimated according to the independent variables (health-related behaviors, morbidities, demographic and socioeconomic characteristics). A hierarchical model was employed using stepwise backward regression in two stages. Principal component analysis was also performed to identify multimorbidity patterns. RESULTS: The prevalence of possible bruxism was 13.6%. Associations were found with the consumption of alcoholic beverages, sleep quality, and the number of chronic diseases/health problems. Bruxism was more associated with multimorbidity pattern 2, which was composed of asthma, rhinitis, sinusitis, dizziness/vertigo, migraine/headache, emotional/mental problem, back pain, and allergy. CONCLUSION: The present findings justify the planning of actions directed at reducing the consumption of alcoholic beverages and can help guide the health actions of the multidisciplinary team, prioritizing a reduction in the harm caused by the simultaneous presence of health problems associated with possible bruxism.

Smoking among Brazilian adolescents during the COVID-19 pandemic: a cross-sectional study

ABSTRACT BACKGROUND: The social distancing measures during the coronavirus disease 2019 (COVID-19) pandemic resulted in mental suffering among adolescents, leading to risky consumption of psychoactive substances such as tobacco. OBJECTIVE: To analyze the factors associated with tobacco use among adolescents during the COVID-19 social distancing period in Brazil. DESIGN AND SETTING: Cross-sectional study used data from ConVid Adolescentes survey in Brazil. METHODS: Tobacco use was assessed before and during social distancing. The explanatory variables investigated were sex, age, race/skin color, type of school, maternal education, region of residence, adherence to social restriction measures, number of close friends, sleep quality during the pandemic, mood, passive smoking, use of alcoholic beverages during the pandemic, sedentary behavior, and physical activity. A logistic regression model was used for the data analysis. RESULTS: Tobacco use by adolescents did not change during the pandemic (from 2.58% to 2.41%). There was a higher chance of tobacco use among adolescents aged between 16 and 17 years, self-reported black ones, residing in the South and Southeast regions, reported feeling sad and loneliness, had sleeping problems that worsened, were using alcoholic beverages during the pandemic, and were passive smokers at home. Adolescents whose mothers had completed high school or higher, had strict social restrictions, and increased their physical activity during the pandemic had a lower chance of tobacco use. CONCLUSION: Tobacco uses during the COVID-19 pandemic was higher in vulnerable groups, such as black adolescents and those with mental suffering.

Alcohol consumption among adolescents during the COVID-19 pandemic, ConVid Adolescents - Behavior Research / O consumo de bebidas alcoólicas entre adolescentes durante a pandemia de COVID-19, ConVid Adolescentes — Pesquisa de Comportamentos

ABSTRACT Objective: To describe the prevalence of alcohol consumption before and during the COVID-19 pandemic and to analyze the factors associated with this behavior during the period of social distancing among Brazilian adolescents. Methods: Cross-sectional study using data from the ConVid Adolescents survey, carried out via the Internet between June and September 2020. The prevalence of alcohol consumption before and during the pandemic, as well as association with sociodemographic variables, mental health, and lifestyle were estimated. A logistic regression model was used to assess associated factors. Results: 9,470 adolescents were evaluated. Alcohol consumption decreased from 17.70% (95%CI 16.64-18.85) before the pandemic to 12.80% (95%CI 11.85-13.76) during the pandemic. Alcohol consumption was associated with the age group of 16 and 17 years (OR=2.9; 95%CI 1.08-1.53), place of residence in the South (OR=1.82; 95%CI 1.46-2.27) and Southeast regions (OR=1.33; 95%CI 1.05-1.69), having three or more close friends (OR=1.78; 95%CI 1.25-2.53), reporting worsening sleep problems during the pandemic (OR=1.59; 95%CI 1.20-2.11), feeling sad sometimes (OR=1,83; 95%CI 1,40-2,38) and always (OR=2.27; 95%CI 1.70-3.05), feeling always irritated (OR=1,60; 95%CI 1,14-2,25), being a smoker (OR=13,74; 95%CI 8.63-21.87) and a passive smoker (OR=1.76; 95%CI 1.42-2.19). Strict adherence to social distancing was associated with lower alcohol consumption (OR=0.40; 95%CI 0.32-0.49). Conclusions: The COVID-19 pandemic led to a decrease in consumption of alcoholic beverages by Brazilian adolescents, which was influenced by sociodemographic and mental health factors, adherence to social restriction measures and lifestyle in this period. Managers, educators, family and the society must be involved in the articulation of Public Policies to prevent alcohol consumption.

RESUMO Objetivo: Descrever as prevalências do consumo de bebidas alcoólicas por adolescentes brasileiros antes e durante a pandemia de COVID-19 e analisar os fatores associados a esse comportamento no período de distanciamento social. Métodos: Estudo transversal, utilizando dados da pesquisa ConVid Adolescentes, realizado via web entre junho e setembro de 2020. Foi estimada a prevalência do consumo de bebidas alcoólicas antes e durante a pandemia e a associação com variáveis sociodemográficas, de saúde mental e estilos de vida. Foi usado modelo de regressão logística para avaliar os fatores associados. Resultados: Avaliaram-se 9.470 adolescentes. O consumo de bebida alcoólica reduziu de 17,70% (IC95% 16,64-18,85), antes da pandemia, para 12,80% (IC95% 11,85-13,76), durante a pandemia. O consumo de bebidas alcoólicas esteve associado à faixa etária de 16 e 17 anos (OR=2,9; IC95% 1,08-1,53), morar na Região Sul (OR=1,82; IC95% 1,46-2,27) e Sudeste (OR=1,33; IC95% 1,05-1,69), ter três ou mais amigos próximos (OR=1,78; IC95% 1,25-2,53), relatar piora dos problemas de sono (OR=1,59; IC95% 1,20-2,11), sentir-se triste às vezes (OR=1,83; IC95% 1,40-2,38) e sempre (OR=2,27; IC95% 1,70-3,05), irritado sempre (OR=1,60; IC95% 1,14-2,25), ser fumante ativo (OR=13,74; IC95% 8,63-21,87) e fumante passivo (OR=1,76; IC95% 1,42-2,19). A adesão à restrição de forma muito rigorosa associou-se ao menor consumo de bebidas alcoólicas (OR=0,40; IC95% 0,32-0,49). Conclusão: A pandemia causada pela COVID-19 levou à diminuição no consumo de bebidas alcoólicas pelos adolescentes brasileiros, e o consumo durante a pandemia foi influenciado por fatores sociodemográficos, de saúde mental, adesão às medidas de restrição social e estilos de vida. Faz-se necessário o envolvimento de gestores, educadores, família e sociedade na articulação de políticas públicas para evitar o consumo de bebidas alcoólicas.

Doenças crônicas e problemas de saúde de adolescentes: desigualdades segundo sexo / Chronic diseases and health conditions in adolescents: Sex inequalities

RESUMO Objetivo: Estimar as prevalências de doenças crônicas e problemas de saúde em adolescentes de Campinas (SP), observando as diferenças entre os sexos, por faixa etária. Métodos: Estudo em base populacional, com dados do inquérito de saúde ISACamp de 2014/15, cujas entrevistas com adolescentes totalizaram 1.022. Desses entrevistados, 517 eram meninos e 505, meninas; 492 encontravam-se na faixa de dez a 14 anos e 530 tinham entre 15 e 19 anos. As associações foram verificadas por meio do teste de χ² com ajuste de Rao Scott, e as razões de prevalência (RP) foram estimadas por meio de regressão múltipla de Poisson ajustadas por idade. Também foram feitas análises estratificadas por faixa etária. Resultados: As doenças respiratórias foram as mais prevalentes nos adolescentes como rinite (25,3%), sinusite (15,7%) e asma (10,9%). As queixas de saúde apresentaram-se elevadas, destacando-se as dores de cabeça (39,5%), problemas emocionais (34,5%), alergias (27,5%) e dores nas costas (21,3%). O número de adolescentes que apontaram ter três ou mais problemas de saúde mostrou-se acima de 22,0%. As meninas referiram maior número de problemas de saúde (três ou mais) do que os meninos (RP=2,27). Conclusão: O estudo demonstrou que os adolescentes apresentaram número expressivo de problemas de saúde, principalmente em relação às queixas, sinalizando que são necessários cuidados clínicos e políticas públicas direcionadas para o controle e prevenção desses agravos nesta faixa etária.

ABSTRACT Objective: To estimate the prevalence of chronic diseases and health conditions in adolescents from Campinas (São Paulo), investigating sex differences according to age group. Methods: This population-based study analyzed data from the ISACamp 2014/15 health survey, with a total of 1,022 adolescents interviewed. The interviewees consisted of 517 boys and 505 girls; 492 of them in the ten to 14 age group and 530 in the 15 to 19 age group. We verified the associations using the χ2 test with Rao Scott adjustment and estimated prevalence ratios (PR) with multiple Poisson regression adjusted for age. Analyses were also stratified by age group. Results: Respiratory diseases, such as rhinitis (25.3%), sinusitis (15.7%), and asthma (10.9%), were the most prevalent among adolescents. Health complaints were high, especially headaches (39.5%), emotional conditions (34.5%), allergies (27.5%), and back pain (21.3%). More than 22.0% of adolescents reported having three or more health conditions. Girls declared a higher number of health conditions (three or more) than boys (PR=2.27). Conclusion: The study showed that adolescents presented a significant number of health conditions, particularly regarding complaints, indicating the need for clinical care and public policies aimed at controlling and preventing these diseases in this age group.

Alcohol consumption among adolescents during the Covid 19 pandemic, Convid Adolescents ­ Behavior Research / O consumo de bebidas alcóolicas entre adolescentes durante a pandemia do Covid 19, Convid Adolescentes - Pesquisa de Comportamentos

Objective: To describe the prevalence of alcohol consumption before and during the Covid 19 pandemic and to analyze the factors associated with this behavior during the period of social distancing in Brazilian adolescents. Methods: Cross-sectional study, using data from the Convid Adolescents survey, carried out via the web between June and September 2020. The prevalence of alcohol consumption before and during the pandemic and association with sociodemographic variables, mental health, lifestyles was estimated. A logistic regression model was used to assess associated factors. Results: 9,470 adolescents were evaluated. Alcohol consumption decreased from 17.70% (95%CI: 16.64;18.85) before the pandemic to 12.80% (95%CI: 11.85;13.76) during the pandemic. Higher alcohol consumption was associated with the age group of 16 and 17 years (OR=2.9;1.08-1.53), living in the South region (OR=1.82;1.46;2.27) and Southeast (OR=1.33;1.05;1.69), having 03 or more close friends (OR=1.78;1.25;2.53), reporting worsening sleep problems during the pandemic (OR=;1.59;1.20;2.11), feeling sad sometimes and always (OR=2.27;1.70;3.05), always irritated, being a smoker (OR=13, 74;8.63;21.87) and passive smoking (OR=1.76;1.42;2.19) were associated with higher alcohol consumption. Adherence to the restriction in a very strict way was associated with lower alcohol consumption (OR=0.40;0.32;0.49). Conclusions: The pandemic caused by Covid 19 led to a decrease in the consumption of alcoholic beverages by Brazilian adolescents, being influenced by sociodemographic and mental health factors, adherence to social restriction measures and lifestyle. It is necessary to involve managers, educators, family and society in the articulation of Public Policies for the prevention of alcohol consumption.

Objetivo: Descrever as prevalências de consumo de bebidas alcoólicas antes e durante a pandemia de Covid 19 e analisar os fatores associados a esse comportamento durante o período de distanciamento social em adolescentes brasileiros. Métodos: Estudo transversal, utilizando os dados da pesquisa Convid Adolescentes, realizada via web entre junho e setembro de 2020. Foi estimada a prevalência do consumo de álcool antes e durante a pandemia e associação com variáveis sociodemográficas, saúde mental, estilos de vida. Foi utilizado modelo de regressão logística para avaliar os fatores associados. Resultados: Foram avaliados 9.470 adolescentes. O consumo de bebida alcoólica reduziu de 17,70% (IC95%: 16,64;18,85) antes da pandemia, para 12,80% (IC95%: 11,85;13,76) durante a pandemia. O maior consumo de álcool esteve associado a faixa etária de 16 e 17 anos (OR=2,9;1,08-1,53), morar na região Sul (OR=1,82;1,46;2,27) e Sudeste (OR=1,33;1,05;1,69), ter 03 ou mais amigos próximos (OR=1,78;1,25;2,53), relatar piora dos problemas de sono durante a pandemia (OR=;1,59;1,20;2,11), sentir-se triste às vezes e sempre (OR=2,27;1,70;3,05), irritado sempre, ser fumante (OR=13,74;8,63;21,87) e fumante passivo (OR=1,76;1,42;2,19) se associaram ao maior consumo de álcool. A adesão à restrição de forma muito rigorosa associou-se ao menor consumo de álcool (OR=0,40;0,32;0,49). Conclusões: A pandemia causada pela Covid 19 levou à diminuição no consumo de bebidas alcóolicas pelos adolescentes brasileiros, sendo influenciada por fatores sociodemográficos, de saúde mental, adesão as medidas de restrição social e estilo de vida. Faz-se necessário o envolvimento de gestores, educadores, família e sociedade na articulação de Políticas Públicas para prevenção do consumo de álcool.

Race (black-white) and sex inequalities in tooth loss: A population-based study.

The effect of health inequalities is determined by different socioeconomic, sex, and race conditions. This study aimed to analyze the association of tooth loss with race (defined by self-reported skin color) and sex. Based on the hypothesis that the association between tooth loss and race may be modified by sex, we also aimed to evaluate possible interactions between race and sex in association with this event, in a population-based study in the city of Campinas, Brazil. A directed acyclic graph was used to select covariates. The prevalence, of tooth loss was 19% higher in black women compared to white men (Prevalence ratio [PR]: 1.19; 95%CI: 1.05-1.34). Moreover, the prevalence of tooth loss in black women was 26% higher than in white women (PR: 1.26; 95%CI: 1.13-1.42); and, within the strata of black people, black women had 14% higher dental loss (PR: 1.14; 95%CI: 1.02-1.27) compared to black men. This study found a significant interaction between race and sex in tooth loss, with a disadvantage for black women. In addition, this work contributes to the discussion of health inequities and can support policies for the provision of universal dental care.

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.

Association of self-reported sleep problems with morbidities and multimorbidities according to sex: National Health Survey 2019. / Associação do autorrelato de problemas no sono com morbidades e multimorbidades segundo sexo: Pesquisa Nacional de Saúde 2019.

OBJECTIVE: To evaluate the association between self-reported sleep problems and the presence of non-communicable diseases (NCDs) and multimorbidity, and whether these associations differ by sex. METHODS: This is a cross sectional study performed with data from the Brazilian National Health Survey, 2019. Prevalence ratios between morbidities, the number of NCDs, and the self-report of sleep problems were estimated by Poisson regression with robust variance, according to sex. RESULTS: This study analysed data from 85,531 Brazilians age ≥ 18 years. The self-reported sleep problems were associated with all the herein studied morbidities and multimorbidities. The prevalence of sleep problems was higher in those who stated one or two (PR = 2.37; 95%CI 2.22;2.54) and three or more NCDs (PR = 4.73; 95%CI 4.37;5.11). Prevalence ratios of the association with diabetes, lung disease, mental disease, renal disease and multimorbidities were higher among males. CONCLUSION: NCDs significantly impacted sleep quality, with a particularly stronger association in both, males and females.

Calidad del sueño y experiencias afectivas durante la pandemia de COVID-19 en adultos residentes en el estado de Minas Gerais / Qualidade do sono e vivências afetivas de adultos residentes no estado de minas gerais durante a pandemia de covid-19 / Sleep quality and affective experiences of adults living in the state of minas gerais during the covid-19 pandemic

RESUMO Objetivos: verificar se a adesão à medida de distanciamento social e características sociodemográficas se associam com as alterações percebidas, durante a pandemia de COVID-19, na qualidade do sono e nas vivências afetivas de brasileiros residentes em Minas Gerais. Método: estudo transversal que analisou dados de questionário on-line aplicado a adultos e idosos residentes no estado de Minas Gerais. Foram estimadas prevalências e razões de prevalências, brutas e ajustadas, para as variáveis investigadas. Resultados: entre 35% e 55% dos respondentes referiram alterações nas vivências afetivas, como solidão, tristeza e ansiedade, e alterações do sono durante o período de isolamento social. Em geral, essas alterações foram mais frequentes entre aqueles que realizaram o isolamento de forma intensa ou total, indivíduos do sexo feminino e pessoas mais jovens. Conclusão: no presente estudo, foram observadas alterações importantes na qualidade de sono e nas vivências afetivas da população mineira, atingindo mais as pessoas do sexo feminino, pessoas mais jovens e que fizeram isolamento social intenso. É importante ofertar cuidados em saúde mental a fim de evitar os impactos negativos do distanciamento social em situações de pandemia.

RESUMEN Objetivos: verificar si la adherencia a la medida de distanciamiento social y las características sociodemográficas están asociadas a los cambios percibidos en la calidad del sueño y las experiencias afectivas de los brasileños residentes en Minas Gerais durante la pandemia de COVID-19. Método: estudio transversal que analizó datos de un cuestionario online aplicado a adultos y ancianos residentes en el estado de Minas Gerais. Se estimaron las prevalencias y las razones de prevalencia, brutas y ajustadas, de las variables investigadas. Resultados: entre el 35% y el 55% de los encuestados refieren alteraciones en las vivencias afectivas como soledad, tristeza, ansiedad, y alteraciones del sueño durante el período de aislamiento social. En general, estos cambios fueron más frecuentes entre los que estaban intensa o totalmente aislados, las mujeres y los individuos más jóvenes. Conclusión: en el presente estudio observamos alteraciones importantes en la calidad del sueño y en las vivencias afectivas de la población de Minas Gerais, afectando más al sexo femenino, a las personas más jóvenes y a las que habían estado en intenso aislamiento social. Es importante prestar atención a la salud mental para evitar los efectos negativos del distanciamiento social en situaciones de pandemia.

ABSTRACT Objectives: to verify whether adherence to the social distancing measure and sociodemographic characteristics are associated with perceived changes, during the COVID-19 pandemic, in sleep quality and affective experiences of Brazilians living in Minas Gerais. Method: a cross-sectional study that analyzed data from an online questionnaire applied to adults and older adults living in the state of Minas Gerais. Prevalence values and prevalence ratios, both adjusted and adjusted, were estimated for the variables investigated. Results: between 35% and 55% of the respondents reported changes in affective experiences, such as loneliness, sadness and anxiety, as well as changes in sleep during the social isolation period. In general, those alterations were more frequent among those who adhered to intense or total isolation, female individuals and younger people. Conclusion: in this study, important changes were observed in sleep quality and in the affective experiences of the population of Minas Gerais, affecting more females, younger people and individuals who adhered to intense social isolation. It is important to offer mental health care in order to avoid the negative impacts of social distancing in pandemic situations.

Smoking and loneliness in older adults: a population-based study in Campinas, São Paulo State, Brazil.

This study aims to analyze the relationship between social isolation and loneliness with smoking in older adults. This is a cross-sectional, population-based study performed with 986 individuals aged 60 years or older. Data were collected from the Health Survey of the Municipality of Campinas (ISACamp 2014/2015), state of São Paulo, Brazil. We estimated the prevalence of smoking and smoking cessation according to independent variables and tested the associations using the chi-square test, considering a 5% significance level. Adjusted prevalence ratios were calculated using simple and multiple Poisson regression. Smoking and smoking cessation were not associated with most variables that indicate objective social isolation. "Often or always" loneliness was related to a higher prevalence of smoking (PR = 2.25; 95%CI: 1.38-3.66) whereas loneliness accompanied of self-reported emotional problems or common mental disorders was strongly associated with smoking and with lower smoking cessation (PR = 6.24; 95%CI: 1.37-28.47 and PR = 0.46; 95%CI: 0.28-0.77, respectively). These findings indicate that loneliness is a psychosocial aspect related to tobacco use which hinders smoking cessation in older adults, emphasizing the importance of emotional problems in this association.

Mental health of Brazilian adolescents during the COVID-19 pandemic.

We aimed to assess the factors associated with frequent sadness and nervousness in Brazilian adolescents, during the Covid-19 pandemic, in 9470 adolescents (aged 12-17 years), interviewed from June 27 to September 17, 2020. Prevalences and prevalence ratios were estimated according to socio-demographic variables and factors related to family, school, friends, and health. Brazilian adolescents often felt sad (32.4%) and nervous (48.7%). Higher prevalences of these feelings were related to: being female; aged 15-17 year; from families with financial difficulties; having learned little or nothing with remote education; missing friends; having few friends; family disagreements; having regular/bad health before the pandemic; and worsened health and sleep during the pandemic. Higher prevalence of nervousness was also found in adolescents who worked before the pandemic and those who reported lack of concentration and not knowing if they had COVID-19. Sadness and nervousness in Brazilian adolescents is high and the need for action by the government, schools, health services, and parents to mitigate the impact of the pandemic on the physical and mental health of adolescents. Special attention must be paid to adolescents with previous health problems and those belonging to the most socially vulnerable population.

Effect of chronic non-communicable diseases (CNCDs) on the sleep of Brazilians during the COVID-19 pandemic.

This study aimed to investigate the effect of Chronic Noncommunicable Diseases (CNCDs) on the onset or increase in sleep problems during the COVID-19 pandemic period. The role of the report of sadness or nervousness during the pandemic was also evaluated as a mediator of this association. Data from a behavior survey during COVID-19, conducted in Brazil with 45,161 people (18 years old or older), from April 24 to May 24, 2020, were used. The outcome variable was the onset or increase in sleep problems, and the exposure variable was the presence of CNCDs. The adjusted Odds Ratio of the association between CNCDs and sleep was estimated, and a mediation analysis was performed to test the effect of the report of sadness or nervousness on this association, using the Karlson Holm Breen method. The increase in sleep problems was reported by 44.9% of the population, and 33.9% reported at least one CNCD. The chance of sleep problems was higher among people with diabetes (1.34; 1.05-1.71), hypertension (1.26; 1.06-1.50), and with coronary heart diseases (1.36; 1.13-1.65) or respiratory diseases (1.42; 1.04-1.93). Compared to people without CNCDs, individuals with at least one CNCD had a 36% greater chance of impaired sleep (1.36; 1.19-1.55). The report of sadness or nervousness explained 45.1% of the association between CNCD and sleep. Our findings alert us to care for the emotional state and sleep of chronic patients during the waves of the COVID-19 pandemic, and indicate the need for sleep monitoring in this population.

Smoking and loneliness in older adults: a population-based study in Campinas, São Paulo State, Brazil / Tabagismo e solidão em idosos: um estudo de base populacional em Campinas, São Paulo, Brasil / Tabaquismo y soledad en adultos mayores: un estudio basado en población de Campinas, estado de São Paulo, Brasil

This study aims to analyze the relationship between social isolation and loneliness with smoking in older adults. This is a cross-sectional, population-based study performed with 986 individuals aged 60 years or older. Data were collected from the Health Survey of the Municipality of Campinas (ISACamp 2014/2015), state of São Paulo, Brazil. We estimated the prevalence of smoking and smoking cessation according to independent variables and tested the associations using the chi-square test, considering a 5% significance level. Adjusted prevalence ratios were calculated using simple and multiple Poisson regression. Smoking and smoking cessation were not associated with most variables that indicate objective social isolation. "Often or always" loneliness was related to a higher prevalence of smoking (PR = 2.25; 95%CI: 1.38-3.66) whereas loneliness accompanied of self-reported emotional problems or common mental disorders was strongly associated with smoking and with lower smoking cessation (PR = 6.24; 95%CI: 1.37-28.47 and PR = 0.46; 95%CI: 0.28-0.77, respectively). These findings indicate that loneliness is a psychosocial aspect related to tobacco use which hinders smoking cessation in older adults, emphasizing the importance of emotional problems in this association.

O estudo busca analisar a relação entre isolamento social, solidão e tabagismo entre idosos. Trata-se de um estudo transversal de base populacional que incluiu 986 indivíduos com 60 anos ou mais. Os dados foram obtidos do Inquérito de Saúde de Município de Campinas (ISACamp 2014/2015), São Paulo, Brasil. Foram estimadas as taxas de prevalência do tabagismo e da cessação do tabagismo de acordo com as variáveis independentes e testadas as associações através do teste de qui-quadrado, considerando nível de significância de 5%. Foram calculadas as razões de prevalência ajustadas com o uso de regressão de Poisson simples e múltipla. O tabagismo e a cessação do tabagismo não mostraram associação com a maioria das variáveis que indicam isolamento social objetivo, enquanto o relato da solidão muitas vezes ou sempre esteve relacionado a uma maior prevalência de tabagismo (RP = 2,25; IC95%: 1,38-3,66). A solidão, acompanhada pelo autorrelato de problemas emocionais ou a presença de transtornos mentais comuns, esteve fortemente associada com o tabagismo e com menor prevalência de cessação do tabagismo (RP = 6,24; IC95%: 1,37-28,47 e RP = 0,46; IC95%: 0,28-0,77, respectivamente). Os achados sustentam o papel da solidão enquanto aspecto psicossocial relacionado ao uso de tabaco e ao impedimento da cessação do tabagismo em idosos e destacam a importância de problemas emocionais nessa associação.

El objetivo de este estudio fue analizar la relación entre el aislamiento social y la soledad con el hábito de fumar en adultos mayores. Se trata de un estudio transversal basado en población, realizado con 986 individuos con 60 años o mayores. Los datos se recogieron de la Encuesta de Salud de la Ciudad de Campinas (ISACamp 2014/2015), estado de São Paulo, Brasil. Estimamos la prevalencia del hábito de fumar y dejar de fumar según variables independientes y probamos las asociaciones usando el test chi-cuadrado, considerando un nivel de significancia de un 5%. Se calcularon las ratios de prevalencia usando una regresión simple y múltiple de Poisson. Fumar y dejar de fumar no estuvieron asociadas con la mayor parte de variables que indican aislamiento social objetivo, mientras que informar soledad a menudo o siempre estuvo relacionado con una más alta prevalencia de tabaquismo (RP = 2,25; IC95%: 1,38-3,66). Soledad acompañada de problemas emocionales autoinformados o la presencia de desórdenes mentales comunes estuvo fuertemente asociado con el tabaquismo y con una menor prevalencia de dejar de fumar (RP = 6,24; IC95%: 1,37-28,47 y RP = 0,46; IC95%: 0,28-0,77, respectivamente). Estos resultados apoyan el papel de la soledad como un aspecto psicosocial relacionado con el consumo de tabaco y el impedimento de dejar de fumar en adultos mayores, además de subrayar la importancia de problemas emocionales en esta asociación.

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.

Associação do autorrelato de problemas no sono com morbidades e multimorbidades segundo sexo: Pesquisa Nacional de Saúde 2019 / Asociación de los problemas de sueño autoinformados con morbilidades y multimorbilidades según el sexo: Encuesta Nacional 2019 / Association of self-reported sleep problems with morbidities and multimorbidities according to sex: National Health Survey 2019

Objetivo: Avaliar a associação do autorrelato de problemas no sono com a presença de doenças crônicas não transmissíveis (DCNTs) e multimorbidades, e se essas associações diferem por sexo. Métodos: Estudo transversal realizado com dados da Pesquisa Nacional de Saúde 2019. Razões de prevalências entre morbidades, número de DCNTs e autorrelato de problemas no sono foram estimadas por regressão de Poisson com variância robusta, por sexo. Resultados: Foram analisados 85.531 brasileiros com idade ≥18 anos. Os problemas no sono autorrelados associaram-se a todas as morbidades e multimorbidades. A prevalência dos problemas no sono foi maior nos que declararam uma ou duas (RP = 2,37; IC95% 2,22;2,54) e três ou mais DCNTs (RP = 4,73; IC95% 4,37;5,11). As razões de prevalências da associação com diabetes, doenças pulmonares, mentais, renais e multimorbidades foram mais elevadas entre o sexo masculino. Conclusão: As DCNTs impactaram significativamente a qualidade do sono em ambos os sexos, com associação mais forte para o sexo masculino.

Objetivo: Evaluar la asociación de problemas de sueño con la presencia de enfermedades crónicas no transmisibles (ECNTs) y multimorbilidades, y si estas asociaciones difieren por sexo. Métodos: Estudio transversal con datos de la encuesta epidemiológica Pesquisa Nacional de Saúde 2019. Se estimaron las razones de prevalencia entre morbilidades, número de ECNTs y problemas de sueño por regresión de Poisson con variación robusta, por sexo. Resultados: Se analizaron 85.531 brasileños ≥ 18 años. El autoinforme de problemas de sueño se asoció con todas las morbilidades estudiadas y con multimorbilidades. La prevalencia de problemas de sueño fue mayor en aquellos que informaron uno o dos (PR = 2,37; IC95% 2,22;2,54) y tres o más ECNTs (RP = 4,73; IC95%4,37;5,11). Las razones de prevalencia de la asociación de diabetes con enfermedades pulmonares, mentales, renales y multimorbilidades han sido más fuertes en el sexo masculino. Conclusión: Las ECNTs tienen un impacto significativo en la calidad del sueño con fuerte asociación en ambos sexos, masculino y feminino.

Objective: To evaluate the association between self-reported sleep problems and the presence of non-communicable diseases (NCDs) and multimorbidity, and whether these associations differ by sex. Methods: This is a cross sectional study performed with data from the Brazilian National Health Survey, 2019. Prevalence ratios between morbidities, the number of NCDs, and the self-report of sleep problems were estimated by Poisson regression with robust variance, according to sex. Results: This study analysed data from 85,531 Brazilians age ≥ 18 years. The self-reported sleep problems were associated with all the herein studied morbidities and multimorbidities. The prevalence of sleep problems was higher in those who stated one or two (PR = 2.37; 95%CI 2.22;2.54) and three or more NCDs (PR = 4.73; 95%CI 4.37;5.11). Prevalence ratios of the association with diabetes, lung disease, mental disease, renal disease and multimorbidities were higher among males. Conclusion: NCDs significantly impacted sleep quality, with a particularly stronger association in both, males and females.

Inequalities in the use of health services by adults and elderly people with and without noncommunicable diseases in Brazil, 2019 National Health Survey.

OBJECTIVE: The objective of this study was to investigate the use of health services and limitations in performing usual activities by adults and elderly people with and without noncommunicable chronic diseases (NCDs), according to sociodemographic strata. METHODS: This is a cross-sectional study in which data from the 2019 National Health Survey were analyzed. The final sample corresponded to 88,531 households with interviews carried out, referring to individuals aged 18 years and above. The prevalence of use of services by the population with NCDs was compared with that of the population without NCDs and stratified by socioeconomic and demographic variables. Prevalence ratios (PRs) and 95% confidence intervals (95%CI) were calculated. RESULTS: In 2019, 47.6% (95%CI 47.0-48.3) of the population reported having one or more NCDs. Population with NCDs had more medical consultations in the last 12 months (adjusted PR [APR]=1.21; 95%CI 1.20-1.23), used more health services in the last 2 weeks (APR=2.01; 95%CI 1.91-2.11), were referred to more hospitalization (APR=2.11; 95%CI 1.89-2.36), and had more limitations in performing usual activities (APR=2.52; 95%CI 2.30-2.76), compared with the population without NCDs. A positive dose-response gradient was observed between the number of comorbidities and the use of services. In all socioeconomic and demographic strata, the prevalence of indicators was higher in people with NCDs. CONCLUSION: The presence of NCDs was associated with a higher frequency of use of health services (i.e., consultation, use of services, and hospitalization) and the restriction of usual activities in all socioeconomic and demographic strata.