Association of self-reported sleep disturbances with ideal cardiovascular health in Brazilian adults: A cross-sectional population-based study.

OBJECTIVE: To examine the association between sleep disturbances and cardiovascular health in Brazilian adults. METHODS: We analyzed cross-sectional data from a nationally representative sample of 36,480 Brazilian adults ages 18 and over. Multivariate Poisson regression models were used to assess the association between sleep disturbances (difficulty falling asleep, frequent interruptions in sleep, or sleeping more than usual) and Life's Simple 7 (LS7) cardiovascular health (CVH) scores through consideration of four behaviors (smoking, physical activity, body mass index, and diet) and three biological factors (hypercholesterolemia, hypertension, and diabetes). RESULTS: Adults with no sleep disturbances had better CVH, with higher mean LS7 CVH scores (4.2, 95% confidence interval [CI]: 4.1; 4.2) when compared to those experiencing some level of sleep disturbance within a 2-week timespan (3.8, 95% CI: 3.7; 3.8). Specifically, compared to those with no sleep disturbance, adults reporting sleep disturbances for half of the weekdays had significantly lower LS7 CVH mean scores (ß = -0.02, 95% CI: -0.04; 0.01). Adults who had disturbances more than half of the weekdays had even lower scores (ß = -0.06, 95% CI: -0.09; -0.02), followed by those who reported disturbances almost every day (ß = -0.08, 95% CI: -0.11; -0.04), even after adjusting for age, sex, education status, depressive symptoms, and night shift work. CONCLUSION: Brazilian adults with sleep disturbances are less likely to achieve ideal CVH. Given that sleep disturbances seem to be increasingly common in Brazil, recent gains in CVH mortality may be affected.

Social vulnerability associated with the self-reported diagnosis of type II diabetes: a multilevel analysis.

OBJECTIVE: To analyze the contextual factors associated with type II diabetes mellitus in Belo Horizonte City. METHODS: Cross-sectional study with 5,779 adults living in Belo Horizonte City, participating in the Risk and Protection Factors Surveillance System for Chronic Diseases through Telephone Survey (Vigitel), in 2008, 2009, and 2010. Multilevel regression models were used to test the association between contextual indicators of physical and social environments, and self-reported diagnosis of diabetes, adjusted for individual sociodemographic and lifestyle factors. Descriptive analyzes and multilevel logistic regression models were used, considering a 5% significance level. RESULTS: The prevalence of diabetes was 6.2% (95%CI 5.54 - 6.92), and 3.1% of the variability of chance of presenting diabetes were explained by contextual characteristics. Living in areas with high density of private places for physical activity and high income was associated with a lower chance of having diabetes. The areas with high level of social vulnerability were strongly associated with the chance of presenting diabetes, adjusted for individual characteristics. CONCLUSION: Characteristics of physical and social environments were associated with the chance of diabetes occurrence. Urban centers with opportunities to adopt healthy behaviors can help to reduce the occurrence of diabetes and its complications.

Spatial analysis of leisure-time physical activity in an urban area.

OBJECTIVE: To analyze the spatial distribution of the prevalence of leisure-time physical activity (LTPA) in a Brazilian urban area and its association with the characteristics of the physical and social environments. METHODS: A cross-sectional study conducted with data from the Surveillance System for Risk and Protective Factors for Chronic Diseases from the years 2008-2010, in Belo Horizonte, state of Minas Gerais, Brazil. The outcome was the practice of LTPA and the independent variables were residential and population density, the density of places for physical activity, homicide rates, average family income, and health vulnerability index. The spatial scanning technique was employed to identify clusters with a high prevalence of PA at leisure time. The Mann-Whitney test was used to compare variables inside and outside the cluster. RESULTS: The sample included 5,779 participants, 33.3% (SE = 0.73) of whom reported sufficient PA during leisure time. We identified a significant cluster of a high prevalence of LTPA. After adjustments, the cluster presented a radius of 3,041.99 meters and 603 individuals, and 293 (48.6%) of them reported sufficient LTPA. The probability of performing sufficient LTPA in the cluster was 27% higher (PR = 1.27; p = 0.002) than in the coverage areas of primary healthcare units outside the cluster. There was a higher density of places for LTPA practice, higher population and residential density, and higher family income in the cluster. CONCLUSION: The results evidenced a cluster of high prevalence of LTPA in a privileged physical and socioeconomic environment in Belo Horizonte, even after adjustments, demonstrating that reducing inequalities can increase LTPA.

Social vulnerability associated with the self-reported diagnosis of type II diabetes: a multilevel analysis / Vulnerabilidade social se associa com o diagnóstico autorreferido de diabetes tipo II: uma análise multinível

ABSTRACT: Objective: To analyze the contextual factors associated with type II diabetes mellitus in Belo Horizonte City. Methods: Cross-sectional study with 5,779 adults living in Belo Horizonte City, participating in the Risk and Protection Factors Surveillance System for Chronic Diseases through Telephone Survey (Vigitel), in 2008, 2009, and 2010. Multilevel regression models were used to test the association between contextual indicators of physical and social environments, and self-reported diagnosis of diabetes, adjusted for individual sociodemographic and lifestyle factors. Descriptive analyzes and multilevel logistic regression models were used, considering a 5% significance level. Results: The prevalence of diabetes was 6.2% (95%CI 5.54 - 6.92), and 3.1% of the variability of chance of presenting diabetes were explained by contextual characteristics. Living in areas with high density of private places for physical activity and high income was associated with a lower chance of having diabetes. The areas with high level of social vulnerability were strongly associated with the chance of presenting diabetes, adjusted for individual characteristics. Conclusion: Characteristics of physical and social environments were associated with the chance of diabetes occurrence. Urban centers with opportunities to adopt healthy behaviors can help to reduce the occurrence of diabetes and its complications.

RESUMO: Objetivo: Analisar os fatores contextuais associados ao diabetes mellitus tipo II em Belo Horizonte (MG). Métodos: Estudo transversal com 5.779 adultos residentes em Belo Horizonte, participantes do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico, nos anos de 2008, 2009 e 2010. Foram utilizados modelos de regressão multinível para testar a associação entre indicadores contextuais do ambiente físico e social e diagnóstico autorreferido de diabetes, ajustados por fatores individuais sociodemográficos e de estilo de vida. Utilizaram-se análises descritivas e modelos de regressão logística multinível, considerando um nível de significância de 5%. Resultados: A prevalência de diabetes foi de 6,2% (IC95% 5,54-6,92), e 3,1% da variabilidade da chance de diabetes nas áreas de abrangência estudadas foi explicada por características contextuais. Residir em áreas com alta densidade de locais privados para prática de atividade física e com alta renda associou-se a menor chance de ter diabetes. As áreas com alto índice de vulnerabilidade social foram fortemente associadas ao diabetes, independentemente de características individuais. Conclusão: A ocorrência de diabetes está associada com as características do ambiente físico e social. Centros urbanos com oportunidades para adoção de comportamentos saudáveis podem ajudar a reduzir a ocorrência de diabetes e as suas complicações.

Spatial analysis of leisure-time physical activity in an urban area / Análise espacial da prática de atividade física no lazer em área urbana

ABSTRACT: Objective: To analyze the spatial distribution of the prevalence of leisure-time physical activity (LTPA) in a Brazilian urban area and its association with the characteristics of the physical and social environments. Methods: A cross-sectional study conducted with data from the Surveillance System for Risk and Protective Factors for Chronic Diseases from the years 2008-2010, in Belo Horizonte, state of Minas Gerais, Brazil. The outcome was the practice of LTPA and the independent variables were residential and population density, the density of places for physical activity, homicide rates, average family income, and health vulnerability index. The spatial scanning technique was employed to identify clusters with a high prevalence of PA at leisure time. The Mann-Whitney test was used to compare variables inside and outside the cluster. Results: The sample included 5,779 participants, 33.3% (SE = 0.73) of whom reported sufficient PA during leisure time. We identified a significant cluster of a high prevalence of LTPA. After adjustments, the cluster presented a radius of 3,041.99 meters and 603 individuals, and 293 (48.6%) of them reported sufficient LTPA. The probability of performing sufficient LTPA in the cluster was 27% higher (PR = 1.27; p = 0.002) than in the coverage areas of primary healthcare units outside the cluster. There was a higher density of places for LTPA practice, higher population and residential density, and higher family income in the cluster. Conclusion: The results evidenced a cluster of high prevalence of LTPA in a privileged physical and socioeconomic environment in Belo Horizonte, even after adjustments, demonstrating that reducing inequalities can increase LTPA.

RESUMO: Objetivo: Analisar a distribuição espacial da prevalência da prática de atividade física (AF) no lazer suficiente em uma área urbana brasileira, no período de 2008 a 2010, e verificar se ela é influenciada por características dos ambientes físico e social. Métodos: Estudo transversal com dados do sistema de Vigilância de Fatores de Risco para doenças crônicas não transmissíveis, realizado em Belo Horizonte (MG), entre os anos 2008 e 2010. O desfecho foi a realização de AF no lazer e as exposições foram densidade residencial e populacional, densidade de locais de prática de AF no lazer, taxa de homicídio, renda familiar média e índice de vulnerabilidade da saúde. Foi empregada a técnica de varredura espacial para identificar clusters de alta prevalência de AF no lazer. Utilizou-se o teste de Mann-Whitney para comparar variáveis ambientais dentro e fora do cluster. Resultados: A amostra foi constituída de 5.779 participantes, dos quais 33,3% referiram praticar AF no lazer suficientemente. Identificou-se um cluster significativo de alta prevalência de prática de AF no lazer. Após ajustes, ele apresentou raio de 3.041,99 m e 603 indivíduos, dos quais 293 (48,6%) realizavam AF no lazer suficiente. A probabilidade de um indivíduo praticar AF no lazer suficiente no cluster foi 27% maior (razão de prevalência — RP = 1,27; p = 0,002) do que nas áreas de abrangência das unidades básicas de saúde não pertencentes a ele. Esse cluster teve maior densidade de locais para a prática de AF no lazer, maior densidade populacional e residencial e maior renda familiar. Conclusão: Constatou-se cluster de alta prevalência de AF no lazer em um contexto físico e econômico privilegiado de Belo Horizonte, o que demonstra que diminuir desigualdades pode aumentar a prática de AF no lazer.

Spatial analysis of leisure-time physical activity in an urban area / Análise espacial da prática de atividade física no lazer em área urbana

Objective: analyze the spatial distribution of the prevalence of leisure-time physical activity (LPA) in a Brazilian urban area and its association with the characteristics of the physical and social environment. Method: a cross-sectional study with data from the Risk Factors Surveillance system for chronic non-communicable diseases from the years 2008-2010, in Belo Horizonte, MG. The outcome was the performance of LPA and the independent variables were residential and population density, the density of places for physical activity, homicide rates, average family income, health vulnerability index. The spatial scanning technique was employed to identify clusters with a high prevalence of LPA at leisure. The Mann-Whitney test was used to compare variables inside and outside the cluster. Results: the sample included 5,779 participants, 33.26% (EP = 0.73) of whom reported practicing sufficient PA during leisure time. We identified a significant cluster of a high prevalence of LPA. After adjustments, the cluster presented a radius of 3,041.99 meters and 603 individuals, 293 (48.6%) of who practiced sufficient LPA. The probability of practicing sufficient LPA in the cluster was 32% higher (PR= 1.32; p= 0.0016) than in the AAUBS that do not belong to the cluster. There was a higher density of places for LPA practice, higher population and residential density and higher family income in the cluster. Conclusions: The results evidenced a cluster of a high prevalence of LPA in a privileged physical and socioeconomic environment in Belo Horizonte, even after adjustments, demonstrating that reducing inequalities can increase LPA.

Objetivo: analisar a distribuição espacial da prevalência da prática de atividade física suficiente no lazer (AFL) em uma área urbana brasileira, no período de 2008 a 2010, e verificar se esta é influenciada por características do ambiente físico e social. Método: estudo transversal com dados do sistema de Vigilância de Fatores de Risco para doenças crônicas não transmissíveis entre os anos 2008 e 2010, em Belo Horizonte, MG. O desfecho foi a realização de AFL e as exposições foram densidade residencial e populacional, densidade de locais de prática de AFL, taxa de homicídio, renda familiar média e índice de vulnerabilidade à saúde. Foi realizada técnica de varredura espacial para identificar clusters de alta prevalência de AFL. Utilizou-se o teste Mann-Whitney para comparar variáveis ambientais dentro e fora do cluster. Resultados: a amostra foi de 5.779 participantes, dos quais 33,26% referiram praticar AFL suficientemente. Foi identificado um cluster significativo de alta prevalência de prática de AFL. Após ajustes, o cluster apresentou raio de 3.041,99 metros e 603 indivíduos, sendo que 293 destes (48,6%) realizavam AFL suficiente. A probabilidade de um indivíduo praticar AFL suficiente no cluster foi 32% maior (RP=1,32; p=0,0016) do que nas AAUBS não pertencentes ao cluster. Esse cluster teve maior densidade de locais para prática de AFL, maior densidade populacional e residencial e maior renda familiar. Conclusões: foi evidenciado cluster de alta prevalência de AFL em um contexto físico e econômico privilegiado em Belo Horizonte, demonstrando que diminuir desigualdades pode aumentar prática de AF no lazer.

Acidentes de motocicletas em Belo Horizonte e Região Metropolitana: tendência linear da mortalidade de 2000 a 2012 / Accidentes de motocicleta en Belo Horizonte y su Región Metropolitana: tendencia lineal de la mortalidad entre 2000 y 2012 / Motorcycle accidents in Belo Horizonte and its Metropolitan Region: linear mortality trend from 2000 to 2012

OBJETIVO: Descrever o perfil e a evolução da taxa de mortalidade por acidentes de motocicletas em Belo Horizonte e na Região Metropolitana, no período de 2000 a 2012. MÉTODOS: Estudo de série temporal com dados extraídos do Sistema de Informações sobre Mortalidade (SIM) e IBGE. Utilizou-se modelo de regressão linear, com nível de significância de 5%. RESULTADOS: De 2000 a 2012, houve um incremento de 278% dos óbitos. A população mais atingida foi a do sexo masculino, faixa etária de 20 a 29 anos, pele negra/parda, sem companheiros e com escolaridade entre 8 e 11 anos. A taxa de mortalidade elevou-se de 1,7 para 3,58 óbitos/100 mil habitantes, com tendência de aumento (ß=0,25 ao ano; p<0,01). DISCUSSÃO: Houve crescimento da taxa de mortalidade por acidentes de motociclistas. Os resultados deste estudo podem contribuir para a formulação de ações que priorizem a prevenção dos acidentes no público de maior risco.

OBJETIVO: Describir el perfil y la evolución de la tasa de mortalidad por accidentes de motocicleta en Belo Horizonte y su Región Metropolitana entre 2000 y 2012. MÉTODOS: Estudio de serie temporal con datos extraídos del Sistema de Información sobre Mortalidad (SIM) y del IBGE. Se utilizó un modelo de regresión lineal con un nivel de significancia del 5%. RESULTADOS: Entre los años 2000 y 2012 se registró un aumento del 278% en la cantidad de muertes. La población más afectada fue la del sexo masculino, con edades comprendidas entre los 20 y los 29 años, de piel negra/parda, sin pareja y con un nivel de escolaridad de 8 a 11 años. La tasa de mortalidad aumentó de 1,7 a 3,58 muertes por cada 100.000 habitantes, con tendencia a aumentar (ß=0,25 por año; p<0,01). DISCUSIÓN: Se registró un aumento en la tasa de mortalidad por accidentes de motocicleta. Los resultados de este estudio pueden contribuir a formular medidas que prioricen la prevención de accidentes en el público de mayor riesgo.

OBJECTIVE: To describe the profile and evolution of the mortality rate due to motorcycle accidents in Belo Horizonte and its Metropolitan Region, from 2000 to 2012. METHODS: A time series study with data extracted from the Mortality Information System (Sistema de Informações sobre Mortalidade, SIM) and from the IBGE. A linear regression model was used, with a 5% significance level. RESULTS: From 2000 to 2012 there was a 278% increase in the number of deaths. The population most affected was that of male individuals, aged 20 to 29 years old, of black/brown skin, without partners, and with 8 to 11 years of schooling. The mortality rate increased from 1.7 to 3.58 deaths/100,000 inhabitants, with an increasing trend (ß=0.25 per year; p<0.01). DISCUSSION: There was an increase in the mortality rate due to motorcycle accidents. The results of this study can contribute to the formulation of actions that prioritize the prevention of accidents in the public at greatest risk.