[Emotional and attitudinal evaluation of tobacco health warnings among youngsters and adults in Argentina.] / Evaluación emocional y actitudinal de advertencias sanitarias de tabaco en adultos y jóvenes de Argentina.

OBJECTIVE: To evaluate variables of tobacco health warnings associated with their emotional impact, the perception of smoking risks and the perceived effectiveness to avoid tobacco use. MATERIALS AND METHODS: Teenagers (151) and adults (168) evaluated 27 tobacco health warnings selected from the sets used on tobacco packages in Argentina and in other countries. A standardized affective rating-scale system and a structured questionnaire measured respectively the emotional impact (hedonic valence and emotional arousal), and the cognitive-behavioral attributions. The correlation between emotional and cognitive-behavioral evaluations was analyzed by age, sex, education level, smoker status,stage of quitting and susceptibility of non-smokers teenagers. RESULTS: Strong significant correlations between cognitivebehavioral and emotional assessments were observed. The warnings depicting graphic images of tobacco-related injuries and suffering were considered more valuable for tobacco. control, helping quitting and preventing initiation. CONCLUSIONS: Using graphic images with high emotional arousal is recommended for both adults and teenagers.

OBJETIVO: Evaluar el impacto emocional y las respuestas cognitivas y actitudinales de las advertencias sanitarias, para evitar el consumo del tabaco. MATERIAL Y MÉTODOS: Se evaluaron 27 advertencias sanitarias de control del tabaco, procedentes de Argentina y de otros países, en 151 adolescentes y 168 adultos.Se aplicó un instrumento estandarizado para medir valencia y activación emocional y un cuestionario estructurado para la medición cognitivo-actitudinal. Se analizaron las correlaciones según edad y sexo, nivel de instrucción, condición de fumador, etapa de cambio en fumadores y susceptibilidad en adolescentes no fumadores. RESULTADOS: Se observó alta correlación entre las valoraciones cognitivoactitudinales y las emocionales. Las advertencias basadas en imágenes cruentas y de sufrimiento generaron más respuestas actitudinales asociadas con el abandono y la prevención del consumo del tabaco. CONCLUSIONES: Se recomienda el uso de advertencias con altos niveles de activación emocional tanto para adultos como para adolescentes.

Evaluación emocional y actitudinal de advertencias sanitarias de tabaco en adultos y jóvenes de Argentina / Emotional and attitudinal evaluation of tobacco health warnings among youngsters and adults in Argentina

Resumen Objetivo Evaluar el impacto emocional y las respuestas cognitivas y actitudinales de las advertencias sanitarias, para evitar el consumo del tabaco. Material y métodos Se evaluaron 27 advertencias sanitarias de control del tabaco, procedentes de Argentina y de otros países, en 151 adolescentes y 168 adultos. Se aplicó un instrumento estandarizado para medir valencia y activación emocional y un cuestionario estructurado para la medición cognitivo-actitudinal. Se analizaron las correlaciones según edad y sexo, nivel de instrucción, condición de fumador, etapa de cambio en fumadores y susceptibilidad en adolescentes no fumadores. Resultados Se observó alta correlación entre las valoraciones cognitivo-actitudinales y las emocionales. Las advertencias basadas en imágenes cruentas y de sufrimiento generaron más respuestas actitudinales asociadas con el abandono y la prevención del consumo del tabaco. Conclusiones Se recomienda el uso de advertencias con altos niveles de activación emocional tanto para adultos como para adolescentes.

Abstract Objective To evaluate variables of tobacco health warnings associated with their emotional impact, the perception of smoking risks and the perceived effectiveness to avoid tobacco use. Materials and methods Teenagers (151) and adults (168) evaluated 27 tobacco health warnings selected from the sets used on tobacco packages in Argentina and in other countries. A standardized affective rating-scale system and a structured questionnaire measured respectively the emotional impact (hedonic valence and emotional arousal), and the cognitive-behavioral attributions. The correlation between emotional and cognitive-behavioral evaluations was analyzed by age, sex, education level, smoker status, stage of quitting and susceptibility of non-smokers teenagers. Results Strong significant correlations between cognitive-behavioral and emotional assessments were observed. The warnings depicting graphic images of tobacco-related injuries and suffering were considered more valuable for tobacco control, helping quitting and preventing initiation. Conclusions Using graphic images with high emotional arousal is recommended for both adults and teenagers.

Exposición a publicidad y consumo de alimentos en escolares de provincias de Argentina / Exposure to advertising and food consumption in schools in the provinces of Argentina

INTRODUCCIÓN En el contexto de una creciente preocupación mundial por la publicidad infantil de alimentos. Se propuso estudiar en niños escolarizados de Argentina la relación entre la exposición a la televisión, la recordación de publicidades, el significado, intenciones de compra y consumo de productos ultraprocesados (UP) y productos no procesados o mínimamente procesados (NP). MATERIAL y MÉTODO Estudio observacional, en muestra no probabilística de escolares de 8 a 12 años de edad y sus padres de escuelas primarias de 6 jurisdicciones de Argentina. Se aplicaron cuestionarios estructurados a escolares y padres, observación y entrevista al personal de escuelas. Se analizó por SPSS Statistics 18.0. RESULTADOS Se evaluaron 1261 escolares y 778 padres de 20 escuelas. El 48,4% de los escolares (n=610) miraban TV más de 30 horas semanales. El 69,9% rememoraron publicidades televisivas de alimentos UP y 19,8 % para alimentos NP, de similar proporción identificada para publicidad en carteles, Internet y promociones. Respecto a credibilidad, un 20% de los escolares y 35% de los padres manifestó que las publicidades no mienten o lo hacen muy poco. La cantidad de pedidos de compra de los niños a los padres mostró relación significativa en función a las horas promedio de exposición a la televisión destacándose rho =.19 (p<000) entre intensidad de exposición a TV y cantidad de pedidos de UP. Se encontró asociación entre mayor presencia de consumo de algunos alimentos procesados y UP, sólidos y bebidas, con mayores medias de exposición a TV, televisión (p=-0,03; p=-0,002), internet (p=-0,004; p=-0,004), carteles (p=-0,019; p=-0,01), y promociones (p=-0,006; p=-0,003). DISCUSIÓN La frecuencia de exposición de los escolares a publicidad se relaciona significativamente con su rememoración, pedidos de compra a los padres de todo tipo de alimentos, particularmente de procesados y UP. Se ha detectado asociación entre el mayor consumo de algunos alimentos procesados y ultraprocesados y exposición a TV

[Results from the First National School Health Survey: Argentina, 2007]. / Resultados de la Primera Encuesta Nacional de Salud Escolar: Argentina, 2007.

INTRODUCTION: The Global School Health Survey (EMSE, in Spanish) has been implemented globally since 2003 to estimate the prevalence of mayor risk behaviours and protective factors among teenagers aged 13 to 15 year old. In 2007, the first EMSE was implemented in Argentina. OBJECTIVE: To describe the prevalence of certain risk factors among youth attending high school in Argentina. METHODOLOGY: A low stage probabilistic sampling was used to select 50 schools nationwide. All students in randomly selected classes were invited to fill the self-administered questionnaire including 75 questions on demographics, alcohol, tobacco and other drugs use, eating habits, hygiene, violence, mental health, physical activity, sexual activity and protective factors. RESULTS: Overall, the survey was answered by 1980 students from 47 schools. We include in this report data related to alcohol, tobacco and other drugs, weight, physical and sexual activity. In the last 30 days, 56,8% had consumed alcohol and 25,5% cigarettes. Overall, 11,7% had tried an illegal drug in their lifetime. Nineteen percent is overweight and less than 81% has completed the minimum required exercise for their age. Also, 33,6% had already had sex; 10,4% before age 13 and less than half of them always use a contraceptive method. CONCLUSIONS: A high prevalence of sedentarism, overweight and substances use, like alcohol, tobacco and illegal drugs, was shown. The rate of condom use was low.

Resultados de la primera encuesta nacional de salud escolar: Argentina, 2007 / Results from the first national school health survey: Argentina, 2007

Introducción. Desde 2003, se está implementando en todo el orbe la Encuesta Mundial de Salud Escolar (EMSE), para estimar la prevalencia de comportamientos de riesgo y factores de protección entre los adolescentes de 13 a 15 años. En 2007 se aplicó por primera vez en la Argentina.Objetivo. Describir la prevalencia de factores de riesgo en la población adolescente escolarizada de la Argentina. Metodología. Se utilizó un muestreo aleatorizado bietápico con selección de 50 escuelas a nivel nacional. Los estudiantes de las divisiones elegidas al azar fueron invitados a responder el cuestionario autoadministrado de 75 preguntas sobre datos demográficos, consumo de tabaco, alcohol y otras drogas, comportamiento alimentario, higiene, violencia, salud mental, actividad física, comportamiento sexual y factores de protección. Resultados. La encuesta fue respondida por 1980 alumnos de 47 escuelas. Se incluyen en este informe los datos sobre consumo de sustancias psicoactivas (licitas e ilícitas), peso corporal, actividad física y salud reproductiva. Se observa que el 56,8 por ciento de los jóvenes consumió alcohol y el 25,5 por ciento fumó cigarrillos durante el último mes.La prevalencia de vida de drogas ilícitas fue del 11,7 por ciento. El 19 por ciento de los encuestados padece de sobrepeso. El 81 por ciento no realiza el mínimo de actividad física sugerido para la edad. El 33,6 por ciento tuvo relaciones sexuales, 10,4 por ciento comenzó a tenerlas antes de los 13 años y menos de la mitad utiliza siempre algún método anticonceptivo. Conclusiones. Se observó una elevada prevalencia de sedentarismo, sobrepeso y de consumo de sustancias como alcohol, drogas y tabaco. La utilización de preservativos resultó sumamente baja.

Introduction. The Global School Health Survey (EMSE, in Spanish) has been implemented globally since 2003 to estimate the prevalence of mayor risk behaviours and protective factors among teenagers aged 13 to 15 year old. In 2007, the first EMSE was implemented in Argentina. Objective. To describe the prevalence of certain risk factors among youth attending high school in Argentina. Methodology. A low stage probabilistic sampling was used to select 50 schools nationwide. All students in randomly selected classes were invited to fill the self-administered questionnaire including 75 questions on demographics, alcohol, tobacco and other drugs use, eating habits, hygiene, violence, mental health, physical activity, sexual activity and protective factors. Results. Overall, the survey was answered by 1980 students from 47 schools. We include in this report data related to alcohol, tobacco and other drugs, weight, physical and sexual activity. In the last 30 days, 56,8% had consumed alcohol and 25,5% cigarettes. Overall, 11,7% had tried an illegal drug in their lifetime. Nineteen percent is overweight and less than 81% has completed the minimum required exercise for their age. Also, 33,6% had already had sex; 10,4% before age 13 and less than half of them always use a contraceptive method.Conclusions. A high prevalence of sedentarism, overweight and substances use, like alcohol, tobacco and illegal drugs, was shown. The rate of condom use was low.

Resultados de la primera encuesta nacional de salud escolar: Argentina, 2007 / Results from the first national school health survey: Argentina, 2007

Introducción. Desde 2003, se está implementando en todo el orbe la Encuesta Mundial de Salud Escolar (EMSE), para estimar la prevalencia de comportamientos de riesgo y factores de protección entre los adolescentes de 13 a 15 años. En 2007 se aplicó por primera vez en la Argentina.Objetivo. Describir la prevalencia de factores de riesgo en la población adolescente escolarizada de la Argentina. Metodología. Se utilizó un muestreo aleatorizado bietápico con selección de 50 escuelas a nivel nacional. Los estudiantes de las divisiones elegidas al azar fueron invitados a responder el cuestionario autoadministrado de 75 preguntas sobre datos demográficos, consumo de tabaco, alcohol y otras drogas, comportamiento alimentario, higiene, violencia, salud mental, actividad física, comportamiento sexual y factores de protección. Resultados. La encuesta fue respondida por 1980 alumnos de 47 escuelas. Se incluyen en este informe los datos sobre consumo de sustancias psicoactivas (licitas e ilícitas), peso corporal, actividad física y salud reproductiva. Se observa que el 56,8 por ciento de los jóvenes consumió alcohol y el 25,5 por ciento fumó cigarrillos durante el último mes.La prevalencia de vida de drogas ilícitas fue del 11,7 por ciento. El 19 por ciento de los encuestados padece de sobrepeso. El 81 por ciento no realiza el mínimo de actividad física sugerido para la edad. El 33,6 por ciento tuvo relaciones sexuales, 10,4 por ciento comenzó a tenerlas antes de los 13 años y menos de la mitad utiliza siempre algún método anticonceptivo. Conclusiones. Se observó una elevada prevalencia de sedentarismo, sobrepeso y de consumo de sustancias como alcohol, drogas y tabaco. La utilización de preservativos resultó sumamente baja.(AU)

Introduction. The Global School Health Survey (EMSE, in Spanish) has been implemented globally since 2003 to estimate the prevalence of mayor risk behaviours and protective factors among teenagers aged 13 to 15 year old. In 2007, the first EMSE was implemented in Argentina. Objective. To describe the prevalence of certain risk factors among youth attending high school in Argentina. Methodology. A low stage probabilistic sampling was used to select 50 schools nationwide. All students in randomly selected classes were invited to fill the self-administered questionnaire including 75 questions on demographics, alcohol, tobacco and other drugs use, eating habits, hygiene, violence, mental health, physical activity, sexual activity and protective factors. Results. Overall, the survey was answered by 1980 students from 47 schools. We include in this report data related to alcohol, tobacco and other drugs, weight, physical and sexual activity. In the last 30 days, 56,8% had consumed alcohol and 25,5% cigarettes. Overall, 11,7% had tried an illegal drug in their lifetime. Nineteen percent is overweight and less than 81% has completed the minimum required exercise for their age. Also, 33,6% had already had sex; 10,4% before age 13 and less than half of them always use a contraceptive method.Conclusions. A high prevalence of sedentarism, overweight and substances use, like alcohol, tobacco and illegal drugs, was shown. The rate of condom use was low.(AU)

Feasibility of salt reduction in processed foods in Argentina.

OBJECTIVE: To assess an intervention to reduce salt intake based on an agreement with the food industry. METHODS: Salt content was measured in bakery products through a national survey and biochemical analyses. Low-salt bread was evaluated by a panel of taste testers to determine whether a reduced salt bread could remain undetected. French bread accounts for 25% of the total salt intake in Argentina; hence, reducing its salt concentration from 2% to 1.4% was proposed and tested. A crossover trial was conducted to evaluate the reduction in urinary sodium and blood pressure in participants during consumption of the low-salt bread compared with ordinary bread. RESULTS: Average salt content in bread was 2%. This study evaluated low-salt bread containing 1.4% salt. This reduction remained mostly undetected by the panels of taste testers. In the crossover trial, which included 58 participants, a reduction of 25 milliequivalents in 24 hour urine sodium excretion, a reduction in systolic blood pressure of 1.66 mmHg, and a reduction in diastolic blood pressure of 0.76 mmHg were found during the low-salt bread intake. CONCLUSIONS: The study showed that dietary salt reduction was feasible and well accepted in the population studied through a reduction of salt content in bread. Although the effects on urinary sodium and blood pressure were moderate, a country wide intervention could have a greater public health impact.

Encuesta nacional de factores de riesgo 2009: evolución de la epidemia de enfermedades crónicas no transmisibles en Argentina: estudio de corte transversal / 2009 National risk factors survey: evolution of the epidemic of chronic non communicable diseases in Argentina: cross sectional study

INTRODUCCIÓN: las enfermedades crónicas no transmisibles (ECNT) en Argentina causan o están relacionadas con aproximadamente el 80% de la mortalidad. La forma más costoefectivapara su vigilancia es a través de encuestas de factores de riesgo. En 2009, se realizó la segunda Encuesta Nacional de Factores de Riesgo (ENFR). OBJETIVOS: monitorear la evolución de los principales factores de riesgo de las ECNT y describir su distribuciónen subgrupos. MÉTODOS: Se realizó un muestreo probabilístico, incluyendo a personas de 18 años y más, no institucionalizadas, de la población general, a partir de un muestreo de viviendas de ciudades de más de 5.000 habitantes de todo el país. Fueron incluidos en el relevamiento los principales factores de riesgo de las ECNT al igual que en la primera ENFR (2005). RESULTADOS: se incluyeron a34.372 encuestados, con una tasa de respuesta de 75%. Los factores de riesgo que presentaron una mejoría respecto a la ENFR 2005 a nivel nacional fueron el tabaquismo, la exposición al humo de tabaco ajeno, la realización de mediciones de presión arterial, colesterol y glucemia, mamografías y Papanicolau. Por el contrario, se incrementaron la obesidad, el sedentarismo, la inactividad física y la alimentación no saludable. Las poblaciones más desfavorecidas (de menores ingresos y menor nivel educativo) presentaron peores indicadores. CONCLUSIONES: las políticas de prevención y control de las ECNT deben continuar intensificándose para revertir esta epidemia. Dadoel impacto de las ECNT en el desarrollo y el costo sanitario y social, su abordaje debe priorizarse aún más en la agenda política y sanitaria nacional e internacional.

INTRODUCTION: In Argentina, non-communicable diseases (NCD) account for about 80% of the mortality. Themost cost-effective way for their surveillance is through risk factor surveys. In 2009 we conducted the second National Risk Factor Survey (NRFS). OBJECTIVES: To monitor the evolution of the main risk factors of chronic diseases and describe thedistribution of major risk factors in subgroups. METHODS: A probabilistic sample was performed, including general urban population (cities with more than 5.000 habitants) aged 18and over across the country. The main risk factors for chronic diseases were included in the survey. RESULTS: We included 34.372 respondents, with a response rate of 75%. The risk factorsat the national level that showed improvement compared with 2005 NRFS were smoking, exposure to second hand smoke, blood pressure measurement, cholesterol measurement, glucosemeasurement, mammography and Papanicolau. However, obesity, physical inactivity and unhealthy diets increased.Disadvantaged populations (with lower incomes and less education) had worse indicators. CONCLUSIONS: Policies forprevention and control of NCDs should continue to intensify to reverse this epidemic. Further actions will be needed both at environmental and individual levels. The NCDs, given theirimpact on development and social and health costs, should be highly prioritized into the political and health agendas inour country and globally.

Encuesta nacional de factores de riesgo 2009: Evolución de la epidemia de enfermedades crónicas no transmisibles en Argentina. Estudio de corte transversal / 2009 National Risk Factors Survey: evolution of the epidemic of chronic non communicable diseases in Argentina. Cross sectional study

INTRODUCCION: las enfermedades crónicas no transmisibles (ECNT) en Argentina causan o están relacionadas con aproximadamente el 80

de la mortalidad. La forma más costoefectivapara su vigilancia es a través de encuestas de factores de riesgo. En 2009, se realizó la segunda Encuesta Nacional de Factores de Riesgo (ENFR). OBJETIVOS: monitorear la evolución de los principales factores de riesgo de las ECNT y describir su distribuciónen subgrupos. METODOS: Se realizó un muestreo probabilístico, incluyendo a personas de 18 años y más, no institucionalizadas, de la población general, a partir de un muestreo de viviendas de ciudades de más de 5.000 habitantes de todo el país. Fueron incluidos en el relevamiento los principales factores de riesgo de las ECNT al igual que en la primera ENFR (2005). RESULTADOS: se incluyeron a34.372 encuestados, con una tasa de respuesta de 75

INTRODUCTION: In Argentina, non-communicable diseases (NCD) account for about 80

of the mortality. Themost cost-effective way for their surveillance is through risk factor surveys. In 2009 we conducted the second National Risk Factor Survey (NRFS). OBJECTIVES: To monitor the evolution of the main risk factors of chronic diseases and describe thedistribution of major risk factors in subgroups. METHODS: A probabilistic sample was performed, including general urban population (cities with more than 5.000 habitants) aged 18and over across the country. The main risk factors for chronic diseases were included in the survey. RESULTS: We included 34.372 respondents, with a response rate of 75

. Los factores de riesgo que presentaron una mejoría respecto a la ENFR 2005 a nivel nacional fueron el tabaquismo, la exposición al humo de tabaco ajeno, la realización de mediciones de presión arterial, colesterol y glucemia, mamografías y Papanicolau. Por el contrario, se incrementaron la obesidad, el sedentarismo, la inactividad física y la alimentación no saludable. Las poblaciones más desfavorecidas (de menores ingresos y menor nivel educativo) presentaron peores indicadores. CONCLUSIONES: las políticas de prevención y control de las ECNT deben continuar intensificándose para revertir esta epidemia. Dadoel impacto de las ECNT en el desarrollo y el costo sanitario y social, su abordaje debe priorizarse aún más en la agenda política y sanitaria nacional e internacional (AU)

. The risk factorsat the national level that showed improvement compared with 2005 NRFS were smoking, exposure to second hand smoke, blood pressure measurement, cholesterol measurement, glucosemeasurement, mammography and Papanicolau. However, obesity, physical inactivity and unhealthy diets increased.Disadvantaged populations (with lower incomes and less education) had worse indicators. CONCLUSIONS: Policies forprevention and control of NCDs should continue to intensify to reverse this epidemic. Further actions will be needed both at environmental and individual levels. The NCDs, given theirimpact on development and social and health costs, should be highly prioritized into the political and health agendas inour country and globally (AU)

Feasibility of salt reduction in processed foods in Argentina / Factibilidad de reducir el contenido de sal de los alimentos procesados en la Argentina

OBJECTIVE: To assess an intervention to reduce salt intake based on an agreement with the food industry. METHODS: Salt content was measured in bakery products through a national survey and biochemical analyses. Low-salt bread was evaluated by a panel of taste testers to determine whether a reduced salt bread could remain undetected. French bread accounts for 25 percent of the total salt intake in Argentina; hence, reducing its salt concentration from 2 percent to 1.4 percent was proposed and tested. A crossover trial was conducted to evaluate the reduction in urinary sodium and blood pressure in participants during consumption of the low-salt bread compared with ordinary bread. RESULTS: Average salt content in bread was 2 percent. This study evaluated low-salt bread containing 1.4 percent salt. This reduction remained mostly undetected by the panels of taste testers. In the crossover trial, which included 58 participants, a reduction of 25 milliequivalents in 24hour urine sodium excretion, a reduction in systolic blood pressure of 1.66 mmHg, and a reduction in diastolic blood pressure of 0.76 mmHg were found during the low-salt bread intake. CONCLUSIONS: The study showed that dietary salt reduction was feasible and well accepted in the population studied through a reduction of salt content in bread. Although the effects on urinary sodium and blood pressure were moderate, a countrywide intervention could have a greater public health impact.

OBJETIVO: Evaluar una intervención destinada a reducir el consumo de sal a partir de un convenio con la industria alimentaria. MÉTODOS: Se midió el contenido de sal de los productos de panadería por medio de una encuesta nacional y análisis bioquímicos. Un grupo de catadores evaluó el pan con bajo contenido de sal para determinar si la disminución pasaba inadvertida. Dado que el pan francés representa 25 por ciento del consumo total de sal en la Argentina, se propuso someter a prueba este tipo de pan con una disminución de la concentración de sal de 2 por ciento a 1,4 por ciento. Se realizó un estudio cruzado con el fin de evaluar si los participantes presentaban una concentración urinaria de sodio más baja y una presión arterial menor durante el período en que consumieron pan con bajo contenido de sal respecto del período en que consumieron pan común. RESULTADOS: El pan común contiene un porcentaje promedio de sal de 2 por ciento. En este estudio, el pan con bajo contenido de sal contenía 1,4 por ciento, disminución que, en general, pasó inadvertida a los catadores. En el estudio cruzado, en el que participaron 58 sujetos, la eliminación urinaria de sodio disminuyó 25 miliequivalentes en 24 horas, la presión arterial sistólica bajó 1,66 mmHg y la presión arterial diastólica bajó 0,76 mmHg durante el período en que los participantes consumieron pan con bajo contenido de sal. CONCLUSIONES: El estudio demuestra que es factible reducir la ingesta de sal alimentaria y que la población estudiada considera aceptable que el pan contenga esta menor concentración de sal. Aunque los efectos sobre la concentración urinaria de sodio y la presión arterial fueron moderados, es probable que una intervención nacional tenga repercusiones más importantes para la salud pública.

An average/deprivation/inequality (ADI) analysis of chronic disease outcomes and risk factors in Argentina.

BACKGROUND: Recognition of the global economic and epidemiological burden of chronic non-communicable diseases has increased in recent years. However, much of the research on this issue remains focused on individual-level risk factors and neglects the underlying social patterning of risk factors and disease outcomes. METHODS: Secondary analysis of Argentina's 2005 Encuesta Nacional de Factores de Riesgo (National Risk Factor Survey, N = 41,392) using a novel analytical strategy first proposed by the United Nations Development Programme (UNDP), which we here refer to as the Average/Deprivation/Inequality (ADI) framework. The analysis focuses on two risk factors (unhealthy diet and obesity) and one related disease outcome (diabetes), a notable health concern in Latin America. Logistic regression is used to examine the interplay between socioeconomic and demographic factors. The ADI analysis then uses the results from the logistic regression to identify the most deprived, the best-off, and the difference between the two ideal types. RESULTS: Overall, 19.9% of the sample reported being in poor/fair health, 35.3% reported not eating any fruits or vegetables in five days of the week preceding the interview, 14.7% had a BMI of 30 or greater, and 8.5% indicated that a health professional had told them that they have diabetes or high blood pressure. However, significant variation is hidden by these summary measures. Educational attainment displayed the strongest explanatory power throughout the models, followed by household income, with both factors highlighting the social patterning of risk factors and disease outcomes. As educational attainment and household income increase, the probability of poor health, unhealthy diet, obesity, and diabetes decrease. The analyses also point toward important provincial effects and reinforce the notion that both compositional factors (i.e., characteristics of individuals) and contextual factors (i.e., characteristics of places) are important in understanding the social patterning of chronic diseases. CONCLUSION: The application of the ADI framework enables identification of the regions or groups worst-off for each outcome measure under study. This can be used to highlight the variation embedded within national averages; as such, it encourages a social perspective on population health indicators that is particularly attuned to issues of inequity. The ADI framework is an important tool in the evaluation of policies aiming to prevent or control chronic non-communicable diseases.

[Tobacco use among secondary school students in Argentina]. / Consumo de tabaco en estudiantes de educación secundaria de Argentina.

OBJECTIVES: To evaluate the prevalence of smoking among Argentine adolescents and describe its usage, factors related to taking up the habit, and exposure to second-hand smoke in the home. METHODS: A cross-sectional study conducted through an anonymous survey of students 12-18 years of age in either the 8th grade of basic education or in the second course of high school or polytechnic school. The study took place in 2002 at 239 school within five urban centers of Argentina (Ciudad Autónoma de Buenos Aires, Partidos del Gran Buenos Aires, Gran Córdoba, Gran Mendoza, and Santa Fe). The random sample was stratified by socioeconomic level and rates were calculated according to an expanded sample composed of samplings from each stage. RESULTS: The survey was completed by 11 734 students (50.5% males; 44.1% were 12-14 years of age and 56.7% were 15-18 years). In all, 30.0% of the males and 35.0% of the females were smokers at the time of the survey (22.5% in the 12-14 year age group and 40.1% in the 15-18 group). The main reason given for taking up smoking was "to see what it was like" (43.7%); 44.3% of the students who smoked did so when they felt anxious. In all, 64.5% claimed they wanted to stop and 72.5% had attempted to quit, although fewer than 8% of the smokers had gotten any professional help to do so. The overwhelming majority considered it unhealthy to smoke tobacco (93.5%) and be around second-hand smoke (89.6%). Only 30.4% felt they had not received enough information on detrimental effects of smoking. More than 70% of the adolescents were living with a smoker. CONCLUSIONS: There is a high rate of smoking among Argentine students, especially females. Policies must be established that will prevent smoking initiation in secondary school. Recommendations are to prohibit tobacco-product advertising and to require stronger health warnings labels.

Consumo de tabaco en estudiantes de educación secundaria de Argentina / Tobacco use among secondary school students in Argentina

OBJETIVOS: Evaluar la prevalencia de tabaquismo en adolescentes argentinos y caracterizar el consumo, los factores relacionados con el inicio de este hábito y la exposición al tabaquismo pasivo en el hogar. MÉTODOS: Estudio de corte transversal mediante una encuesta anónima a estudiantes de 12- 18 años de 8.° grado de la educación básica y 2.° curso de la enseñanza superior o polimodal. El estudio se realizó en 2002 en 239 escuelas de cinco urbes argentinas (Ciudad Autónoma de Buenos Aires, Partidos del Gran Buenos Aires, Gran Córdoba, Gran Mendoza y Santa Fe). La muestra aleatoria se estratificó según el nivel socioeconómico y las proporciones se calcularon a partir de la muestra expandida derivada de las fracciones de muestreo de cada etapa. RESULTADOS: Respondieron las encuestas 11 734 alumnos (50,5 por ciento varones; 44,1 por ciento de 12-14 años y 56,7 por ciento de 15-18 años). En general, 30,0 por ciento de los varones y 35,0 por ciento de las mujeres eran fumadores al momento de la encuesta (22,5 por ciento en el grupo de 12-14 años y 40,1 por ciento en el de 15- 18 años). La principal razón alegada para comenzar a fumar fue " para probar" (43,7 por ciento); 44,3 por ciento de los estudiantes que fumaban lo hacía cuando estaban ansiosos. En total, 64,5 por ciento manifestó querer dejar de fumar y 72,5 por ciento de los fumadores intentó dejarlo, aunque menos de 8 por ciento de los fumadores había recibido ayuda profesional para ello. La inmensa mayoría consideró como no saludable el consumo de tabaco (93,5 por ciento) y el humo del tabaco ajeno (89,6 por ciento). Solo 30,4 por ciento refirió no haber recibido información adecuada sobre el daño que provoca el tabaquismo. Más de 70 por ciento de los adolescentes convivía con un fumador. CONCLUSIONES: Existe una alta prevalencia de tabaquismo en los estudiantes argentinos, especialmente en las mujeres. Se deben establecer políticas destinadas a prevenir el inicio del consumo en...

OBJECTIVES: To evaluate the prevalence of smoking among Argentine adolescents and describe its usage, factors related to taking up the habit, and exposure to second-hand smoke in the home. METHODS: A cross-sectional study conducted through an anonymous survey of students 12-18 years of age in either the 8th grade of basic education or in the second course of high school or polytechnic school. The study took place in 2002 at 239 school within five urban centers of Argentina (Ciudad Autónoma de Buenos Aires, Partidos del Gran Buenos Aires, Gran Córdoba, Gran Mendoza, and Santa Fe). The random sample was stratified by socioeconomic level and rates were calculated according to an expanded sample composed of samplings from each stage. RESULTS: The survey was completed by 11 734 students (50.5 percent males; 44.1 percent were 12-14 years of age and 56.7 percent were 15-18 years). In all, 30.0 percent of the males and 35.0 percent of the females were smokers at the time of the survey (22.5 percent in the 12-14 year age group and 40.1 percent in the 15-18 group). The main reason given for taking up smoking was " to see what it was like" (43.7 percent); 44.3 percent of the students who smoked did so when they felt anxious. In all, 64.5 percent claimed they wanted to stop and 72.5 percent had attempted to quit, although fewer than 8 percent of the smokers had gotten any professional help to do so. The overwhelming majority considered it unhealthy to smoke tobacco (93.5 percent) and be around second-hand smoke (89.6 percent). Only 30.4 percent felt they had not received enough information on detrimental effects of smoking. More than 70 percent of the adolescents were living with a smoker. CONCLUSIONS: There is a high rate of smoking among Argentine students, especially females. Policies must be established that will prevent smoking initiation in secondary school. Recommendations are to prohibit tobacco-product advertising and to require stronger...

Encuesta Nacional de Factores de Riesgo 2005: resultados principales: prevalencia de factores de riesgo de enfermedades cardiovasculares en la Argentina / National risk factor survey 2005: main results: prevalence of cardiovascular risk factors in Argentina

Hasta el momento no contábamos con estimaciones a nivel nacional de los principales factores de riesgo de morbimortalidad por enfermedades cardiovasculares que permitieran una estrategia de promoción y prevención primaria. En el marco del desarrollo de políticas de salud pública, el Ministerio de Salud de la Nación inició las actividades para la realización de la primera Encuesta Nacional de Factores de Riesgo. Objetivos: Describir la prevalencia de los principales factores de riesgo de enfermedades cardiovasculares en la Argentina y su asociación con características sociodemográficas. Material y métodos: Desde el 12 marzo y hasta el 17 de junio de 2005 se llevó a cabo la primera Encuesta Nacional de Factores de Riesgo. Se utilizó un cuestionario validado previamente para la Argentina, propuesto por la OPS y la OMS. La muestra fue probabilística, a nivel de viviendas, con representatividad nacional y provincial. Criterio de inclusión: población adulta (18 años y más). Se obtuvieron los principales indicadores de prevalencia de acuerdo con las recomendaciones de los CDC, se evaluaron asociaciones entre características sociodemográficas y se estimó la frecuencia de control de presión arterial y colesterol. Resultados: Se realizaron 41.392 encuestas, con una tasa de respuesta del 86,7 por ciento. Los principales indicadores a nivel nacional fueron: baja actividad física 46,2 por ciento, consumo de tabaco 33,4 por ciento 18 a 64 años y 29,7 por ciento en adultos, presión arterial elevada 34,4 por ciento (en personas que se controlaron), sobrepeso-obesidad 49,1 por ciento, bajo consumo de frutas y verduras 35,3 por ciento, diabetes 11,9 por ciento (en personas que se controlaron), colesterol elevado 27,8 por ciento (en personas que se controlaron), consumo de alcohol de riesgo 9,6 por ciento. Para casi todos los factores de riesgo evaluados se observó mayor prevalencia en la población de menores ingresos, con necesidades básicas insatisfechas y menor nivel educati...

Until present, we had no information available at a national level regarding the main risk factors affecting morbidity and mortality due to cardiovascular diseases, that would allow to undertake a strategy of health promotion and primary prevention. With the goal of developing public health policies, the Ministry of Health has started to work on the first “National Risk Factor Survey”. Objectives To describe the prevalence of the main cardiovascular risk factors in Argentina and their association with sociodemographic characteristics. Material and Methods The first National Risk Factor Survey was conducted from March 12 until June 17, 2005, using a questionnaire proposed by PAHO and the WHO, which was previously validated for Argentina. Homes were surveyed to obtain a probabilistic sample, which was representative at national and provincial levels. The survey included adults, aged 18 years and older. The main prevalence indicators were obtained according to CDC recommendations; the associations between sociodemographic parameters were assessed as well as the rate of control of blood pressure and cholesterol levels. Results A total of 41.392 surveys were performed, with a response rate of 86.7%. The main national indicators were: a low level of physical activity (46.2%), tobacco consumption, which was 33.4% in subjects aged 18 to 64 years and 29.7% in adults of all ages, high blood pressure (33.4%) in people in whom it was measured, overweight-obesity was 49.1%, low consumption of fruits and vegetables: 35.3%, diabetes in 11.9% (in people in whom it was measured), high cholesterol: 27.8% (in people in whom it was measured), while alcohol intake considered “of risk” was 9.6%. For almost all risk factors assessed, the prevalence was higher in lower income populations, with unmet basic needs and lower educational level. Prevalence was also significant in the northeastern and orthwestern provinces of our country. As to the reported control of...

Encuesta Nacional de Factores de Riesgo 2005: resultados principales: prevalencia de factores de riesgo de enfermedades cardiovasculares en la Argentina / National risk factor survey 2005: main results: prevalence of cardiovascular risk factors in Argentina

Hasta el momento no contábamos con estimaciones a nivel nacional de los principales factores de riesgo de morbimortalidad por enfermedades cardiovasculares que permitieran una estrategia de promoción y prevención primaria. En el marco del desarrollo de políticas de salud pública, el Ministerio de Salud de la Nación inició las actividades para la realización de la primera Encuesta Nacional de Factores de Riesgo. Objetivos: Describir la prevalencia de los principales factores de riesgo de enfermedades cardiovasculares en la Argentina y su asociación con características sociodemográficas. Material y métodos: Desde el 12 marzo y hasta el 17 de junio de 2005 se llevó a cabo la primera Encuesta Nacional de Factores de Riesgo. Se utilizó un cuestionario validado previamente para la Argentina, propuesto por la OPS y la OMS. La muestra fue probabilística, a nivel de viviendas, con representatividad nacional y provincial. Criterio de inclusión: población adulta (18 años y más). Se obtuvieron los principales indicadores de prevalencia de acuerdo con las recomendaciones de los CDC, se evaluaron asociaciones entre características sociodemográficas y se estimó la frecuencia de control de presión arterial y colesterol. Resultados: Se realizaron 41.392 encuestas, con una tasa de respuesta del 86,7 por ciento. Los principales indicadores a nivel nacional fueron: baja actividad física 46,2 por ciento, consumo de tabaco 33,4 por ciento 18 a 64 años y 29,7 por ciento en adultos, presión arterial elevada 34,4 por ciento (en personas que se controlaron), sobrepeso-obesidad 49,1 por ciento, bajo consumo de frutas y verduras 35,3 por ciento, diabetes 11,9 por ciento (en personas que se controlaron), colesterol elevado 27,8 por ciento (en personas que se controlaron), consumo de alcohol de riesgo 9,6 por ciento. Para casi todos los factores de riesgo evaluados se observó mayor prevalencia en la población de menores ingresos, con necesidades básicas insatisfechas y menor nivel educati...(AU)

Until present, we had no information available at a national level regarding the main risk factors affecting morbidity and mortality due to cardiovascular diseases, that would allow to undertake a strategy of health promotion and primary prevention. With the goal of developing public health policies, the Ministry of Health has started to work on the first ¶National Risk Factor Survey÷. Objectives To describe the prevalence of the main cardiovascular risk factors in Argentina and their association with sociodemographic characteristics. Material and Methods The first National Risk Factor Survey was conducted from March 12 until June 17, 2005, using a questionnaire proposed by PAHO and the WHO, which was previously validated for Argentina. Homes were surveyed to obtain a probabilistic sample, which was representative at national and provincial levels. The survey included adults, aged 18 years and older. The main prevalence indicators were obtained according to CDC recommendations; the associations between sociodemographic parameters were assessed as well as the rate of control of blood pressure and cholesterol levels. Results A total of 41.392 surveys were performed, with a response rate of 86.7%. The main national indicators were: a low level of physical activity (46.2%), tobacco consumption, which was 33.4% in subjects aged 18 to 64 years and 29.7% in adults of all ages, high blood pressure (33.4%) in people in whom it was measured, overweight-obesity was 49.1%, low consumption of fruits and vegetables: 35.3%, diabetes in 11.9% (in people in whom it was measured), high cholesterol: 27.8% (in people in whom it was measured), while alcohol intake considered ¶of risk÷ was 9.6%. For almost all risk factors assessed, the prevalence was higher in lower income populations, with unmet basic needs and lower educational level. Prevalence was also significant in the northeastern and orthwestern provinces of our country. As to the reported control of...(AU)