Hipertensão arterial e diabetes mellitus em uma região metropolitana de desigualdade social: inquérito populacional / Arterial hypertension and diabetes mellitus in a metropolitan region facing social inequality: a population-based survey / Hipertensión arterial y diabetes mellitus en una región metropolitana desigualdad en social: encuesta poblacional

Objetivo: Estimar a prevalência de hipertensão arterial sistêmica (HAS) e diabetes mellitus (DM) autorreferidas e verificar os fatores associados. Métodos: Estudo transversal realizado em 2015 que utilizou dados do inquérito populacional Saúde em Vespasiano. A amostra compôs-se por 1.206 adultos para os quais se calcularam e compararam-se as razões de prevalências de hipertensão arterial sistêmica (HAS), diabetes mellitus (DM) e HAS+DM e seus respectivos intervalos de confiança de 95%, segundo sexo, faixa etária, escolaridade e renda, utilizando regressão de Poisson com variância robusta. Resultados: Encontraram-se as seguintes prevalências de HAS, DM e HAS+DM, respectivamente, de 21,8%; 7,8% e 5,3%. Para os três grupos de doenças, a prevalência mostrou-se maior em mulheres, com idade superior a 65 anos, ensino fundamental incompleto e renda inferior a dois salários mínimos (valor-p<0,05). Conclusão: A maior prevalência e distribuição de HAS e DM observou-se entre mulheres idosas, com menor tempo de escolaridade e dependentes do Sistema Único de Saúde (SUS).

Objective: To estimate the prevalence of self-reported systemic arterial hypertension (SAH) and diabetes mellitus (DM) and check for associated factors. Methods: A cross-sectional study was carried out in 2015 using data from the Health in Vespasiano population-based survey. The sample consisted of 1,206 adults for whom the prevalence ratios of systemic arterial hypertension (SAH), diabetes mellitus (DM) and SAH+DM and their respective 95% confidence intervals were calculated and compared according to sex, age range, education and income using Poisson regression with robust variance. Results: The prevalence rates of SAH, DM and SAH+DM were, respectively, 21.8%; 7.8% and 5.3%. For the three groups of diseases, the prevalence was higher in women, those aged over 65 years, those with incomplete primary education and those with income below two minimum wages (p-value <0.05). Conclusion: The highest prevalence and distribution of SAH and DM was observed in older women, those with less study time and dependent on the Unified Health System (Sistema Único de Saúde ­ SUS).

Objetivo: Estimar la prevalencia de hipertensión arterial sistémica (HAS) y diabetes mellitus (DM) autorreferidas y verificar los factores asociados. Métodos: Estudio transversal realizado en 2015 que utilizó datos de la encuesta poblacional Salud en Vespasiano. La muestra fue compuesta por 1.206 adultos para los cuales se calcularon y se compararon las razones de prevalencias de hipertensión arterial sistémica (HAS), diabetes mellitus (DM) y HAS+DM y sus respectivos intervalos de confianza de 95%, según sexo, franja etaria, escolaridad y renta, utilizando regresión de Poisson con varianza robusta. Resultados: Fueron encontradas las siguientes prevalencias de HAS, DM y HAS+DM, respectivamente, de 21,8%; 7,8% y 5,3%. Para los tres grupos de enfermedades, la prevalencia se mostró mayor en mujeres, con edad superior a 65 años, enseñanza primaria incompleta y renta inferior a dos salarios mínimos (valor-p<0,05). Conclusión: La mayor prevalencia y distribución de HAS y DM fue observada entre mujeres mayores, con menor tiempo de escolaridad y dependientes del Sistema Único de Salud (SUS).

Individual characteristics, perceived neighborhood, and walking for transportation among older Brazilian people residing in a large urban area.

This study aimed to investigate the association of individual and environmental characteristics with walking for transportation among older Brazilian people living in a large urban area. Data from 825 participants (≥ 60 years) from a multistage household survey in Belo Horizonte, Brazil, were used. Walking for transportation was evaluated using the International Physical Activity Questionnaire. The environmental variables included six perceived neighborhood scales (walkability, quality of services, physical disorder, safety, social disorder, and social cohesion). A Poisson regression analysis with robust variance was performed. The walking for transportation was significantly associated with walkability scale, lower family income (up to four minimum wages), very good/good self-rated health, and high social participation. Our results suggest that promoting adequate conditions for walkability in urban areas, expanding the opportunities for social participation, and improving general health is essential to increase walking levels for transportation among this older Brazilian population.

Perceived neighborhood and fall history among community-dwelling older adults living in a large Brazilian urban area: a multilevel approach.

Few studies have examined the neighborhood features related to falls in the older population in low-and-middle-income countries, including Brazil. This study aimed to evaluate if perceived neighborhood features are related to falls among older Brazilian adults living in a large urban area. This cross-sectional study was conducted using data from 834 participants (≥60 years) from a multistage household survey in Belo Horizonte, Brazil. The association between fall history in the previous year and perceived neighborhood features (quality of services, physical and social disorder, and safety) was examined using multilevel logistic regression. The fall prevalence was 13.6%. Older adults living in neighborhoods with a higher physical disorder were more likely to report fall in the previous year, even after controlling for demographic, clinical and social variables (OR = 2.59; 95% CI = 1.14-5.87). The other neighborhood features investigated were not associated with a fall history. Our findings suggest that improving the physical environment represents an important strategy to prevent falls in the Brazilian urban older population.

Noise annoyance, sociodemographic and health patterns, and neighborhood perceptions in a Brazilian metropolis: BH Health Study.

OBJECTIVE: The present study aims to analyze the association of noise annoyance with individual and sociodemographic factors and self-perception of the neighborhood in an urban center. METHODS: Data were collected through a population-based cross-sectional study held in two of the nine health districts in the city of Belo Horizonte, Minas Gerais, Brazil, from 2008 to 2009. The study included 3,934 individuals of both genders, aged 18 years and older. The response variable was the self-perception of noise, investigated by the question: "In your neighborhood, does the noise bother you?" The explanatory variables were grouped into the following domains: sociodemographic, social determinants, self-rated health, and self-reported diseases. RESULTS: The prevalence of noise annoyance was 47% for women and 39.8% for men. For both genders, noise annoyance was independently associated with bad traffic and the presence of loud music, discussions, and late-night parties. CONCLUSION: Gender differences were identified in the association of noise annoyance with sociodemographic characteristics and self-reported morbidity. Traffic and social customs were the main sources of noise in the regions under study.

Exploring neighborhood socioeconomic disparity in self-rated health: a multiple mediation analysis.

There is still a need for more empirical investigations to better understand the causal pathways by which neighborhood socioeconomic contexts translate into states of health. This study explored the relationship between neighborhood socioeconomic position and health, as well as the role of social cohesion, violence, places to buy healthy food, and sports and leisure spaces in mediating this relationship in a diverse set of neighborhoods in Brazil. We applied a general multiple mediation approach to analyze a cross-sectional survey of 4.046 adults living in 149 neighborhoods in 2008 and 2009. The property value was chosen as an indicator of neighborhood socioeconomic position and self-rated health as the outcome. The four mediators were constructed from the self-perception of the participants. Results: We found that people living in economically advantaged neighborhoods were less likely to report their health as being fair/poor/very poor (OR = 0.71; 95% CI = 0.63, 0.76) than people living in disadvantaged neighborhoods, and this effect was mediated by the perception of violence in the neighborhoods. On average, 8.4% of the neighborhood socioeconomic disparity in self-rated health may be explained by violence. We did not ascertain as mediators social cohesion, places to buy healthy food, and sports and leisure spaces. Violence perception mediates the relationship between neighborhood socioeconomic position and self-rated health. Targeted interventions designed to improve the health status of the population could usefully focus on reducing the level of violence in which people live.

Associations of the perceived neighborhood environment and screen time in adolescents living in a medium-sized city in Brazil: a cross-sectional study.

Individual attributes have been investigated to explain sedentary behavior. However, few studies have evaluated this association at the neighborhood level. This study aimed to determine the association between screen time (ST) among adolescents and perceived neighborhood characteristics. This cross-sectional study was conducted using a multistage household survey in Vespasiano, Brazil, in 2015-2016. Logistic regression analyses were performed to assess the associations between the adolescent self-reported ST (television, computer, and video game > 2 h/day) and neighborhood characteristics (green space, sidewalk maintenance, street lighting, social disorder, safety during the day, and risk of violence) reported by an adult. Four hundred and twenty-three adolescents aged 11-17 participated in the study. ST was reported by 74.0% of the adolescents. After adjustment for confounder variables, neighborhood characteristics did not remain associated with ST. The results evidence no associations between ST among adolescents and perceived neighborhood environment and indicate the need for future studies of this relation.

Noise annoyance, sociodemographic and health patterns, and neighborhood perceptions in a Brazilian metropolis: BH Health Study / Percepção do ruído como incômodo, características sociodemográficas, de saúde e percepção da vizinhança em uma metrópole brasileira: Estudo Saúde em Beagá

ABSTRACT Objective: The present study aims to analyze the association of noise annoyance with individual and sociodemographic factors and self-perception of the neighborhood in an urban center. Methods: Data were collected through a population-based cross-sectional study held in two of the nine health districts in the city of Belo Horizonte, Minas Gerais, Brazil, from 2008 to 2009. The study included 3,934 individuals of both genders, aged 18 years and older. The response variable was the self-perception of noise, investigated by the question: "In your neighborhood, does the noise bother you?" The explanatory variables were grouped into the following domains: sociodemographic, social determinants, self-rated health, and self-reported diseases. Results: The prevalence of noise annoyance was 47% for women and 39.8% for men. For both genders, noise annoyance was independently associated with bad traffic and the presence of loud music, discussions, and late-night parties. Conclusion: Gender differences were identified in the association of noise annoyance with sociodemographic characteristics and self-reported morbidity. Traffic and social customs were the main sources of noise in the regions under study.

RESUMO Objetivo: Analisar a associação entre o incômodo provocado pelo ruído com fatores individuais e sociodemográficos e a autopercepção de vizinhança em um centro urbano. Métodos: Os dados foram coletados por meio de um estudo transversal de base populacional, desenvolvido em dois dos nove distritos sanitários do município de Belo Horizonte, Minas Gerais, no período de 2008 a 2009. Participaram do estudo 3.934 indivíduos, de ambos os sexos, com 18 anos ou mais. A variável resposta foi a autopercepção do ruído, investigada pela pergunta: "Pensando na sua vizinhança o ruído/barulho incomoda você?". As variáveis explicativas foram agrupadas nos seguintes domínios: sociodemográfico, determinantes sociais, autoavaliação de saúde e autorrelato de doenças. Resultados: Para as mulheres, a prevalência do incômodo ao ruído foi de 47%, e para os homens, foi de 39,8%. Para ambos os sexos, o incômodo ao ruído foi independentemente associado ao trânsito ruim e presença de música alta, discussões e festas até tarde. Conclusões: Diferenças entre os sexos foram observadas para associação entre o incômodo ao ruído, características sociodemográficas e morbidade autorreferida. O trânsito e os costumes sociais se configuraram como a principal fonte geradora de ruído nas regiões estudadas.

Is alcohol outlet density in the residential area associated with alcohol consumption among adolescents? / Densidade de estabelecimentos que comercializam bebidas alcoólicas na área residencial está associada ao consumo de álcool em adolescentes?

OBJECTIVE: To investigate the association between the alcohol outlet density in residential areas and the current and lifetime alcohol consumption, adjusted for individual and family factors. METHOD: Information from a three-stage household stratified probabilistic cluster sampling survey (census tract, household, adult and adolescent), conducted in Belo Horizonte, Brazil ("Health in BH", 2008-2009) and data of the establishments were obtained from official sources and subsequently georeferenced. The outcome was the adolescents' report of current and lifetime alcohol consumption. The exposure variable was the alcohol outlet density, defined as the number of establishments within a 200-meter range from the adolescents' residence. The association was estimated by Poisson regression adjusted by individual and family variables. RESULTS: In total, 601 adolescents aged 14 to 17 years were included in this study. Of these, 53.3% were males and 71.0% lived in a family with income up to five minimum wages. The prevalence of lifetime alcohol consumption was 57.0% (95%CI 51.5 - 62.6) and the current was 11.9% (95%CI 8.7 - 15.0). The multivariate analysis showed a significant association between current alcohol consumption and density of snack bars (PR = 1.13; 95%CI 1.03 - 1.24), bars (PR = 1.21; 95CI% 1.05 - 1.38), and restaurants (PR = 1.11; 95%CI 1.02 - 1.21). Significant interactions between density of establishments with sex and age were found. CONCLUSION: Current alcohol consumption may be enhanced by the availability of some types of establishments located within a range of 200 meters from the adolescents' residence.

Densidade de estabelecimentos que comercializam bebidas alcoólicas na área residencial está associada ao consumo de álcool em adolescentes? / Is alcohol outlet density in the residential area associated with alcohol consumption among adolescents?

RESUMO: Objetivos: Investigar a associação entre a densidade de estabelecimentos de venda de bebidas alcoólicas no entorno da residência dos adolescentes e a prevalência de consumo de álcool na vida e atual, ajustado por fatores individuais e familiares. Métodos: As informações provêm da pesquisa domiciliar por amostragem probabilística estratificada e por conglomerados em três estágios (setor censitário, domicílio, adulto e adolescente), realizada em Belo Horizonte, Brasil (Saúde em Beagá, 2008-9) e de fontes oficiais de estabelecimentos que comercializam bebidas alcoólicas, devidamente georreferenciados. O desfecho foi o autorrelato de consumo de álcool na vida e atual pelos adolescentes. A variável de exposição foi a densidade de estabelecimentos definida como número de locais de venda de bebida dentro do buffer de 200 metros da residência dos adolescentes. A associação foi estimada pela regressão de Poisson ajustada por fatores individuais e familiares. Resultados: Participaram 601 adolescentes de 14-17 anos; 53,3% eram homens e 71% tinham renda familiar até cinco salários mínimos. A prevalência de consumo de álcool na vida foi de 57,0% (intervalo de confiança de 95% - IC95% 51,5 - 62,6) e o atual de 11,9% (IC95% 8,7 - 15,0). Na análise multivariada, verificou-se associação significativa entre o consumo atual de bebidas alcoólicas e a densidade de lanchonetes (razão de prevalência - RP = 1,13; IC95% 1,03 - 1,24), bares (RP = 1,21; IC95% 1,05 - 1,38) e restaurantes (RP = 1,11; IC95% 1,02 - 1,21). Interações significativas entre densidade de estabelecimentos com sexo e idade foram encontradas. Conclusão: O consumo atual de álcool pode ser potencializado pela presença de alguns tipos de estabelecimentos localizados no buffer de 200 metros da residência dos adolescentes.

ABSTRACT: Objective: To investigate the association between the alcohol outlet density in residential areas and the current and lifetime alcohol consumption, adjusted for individual and family factors. Method: Information from a three-stage household stratified probabilistic cluster sampling survey (census tract, household, adult and adolescent), conducted in Belo Horizonte, Brazil ("Health in BH", 2008-2009) and data of the establishments were obtained from official sources and subsequently georeferenced. The outcome was the adolescents' report of current and lifetime alcohol consumption. The exposure variable was the alcohol outlet density, defined as the number of establishments within a 200-meter range from the adolescents' residence. The association was estimated by Poisson regression adjusted by individual and family variables. Results: In total, 601 adolescents aged 14 to 17 years were included in this study. Of these, 53.3% were males and 71.0% lived in a family with income up to five minimum wages. The prevalence of lifetime alcohol consumption was 57.0% (95%CI 51.5 - 62.6) and the current was 11.9% (95%CI 8.7 - 15.0). The multivariate analysis showed a significant association between current alcohol consumption and density of snack bars (PR = 1.13; 95%CI 1.03 - 1.24), bars (PR = 1.21; 95CI% 1.05 - 1.38), and restaurants (PR = 1.11; 95%CI 1.02 - 1.21). Significant interactions between density of establishments with sex and age were found. Conclusion: Current alcohol consumption may be enhanced by the availability of some types of establishments located within a range of 200 meters from the adolescents' residence.

Built and Social Environment by Systematic Social Observation and Leisure-Time Physical Activity Report among Brazilian Adults: a Population-Based Study.

The aim of this study was to investigate the relationship between built and social environment and leisure-time physical activity (LTPA) among adults living in an urban center. The individual data was from the household survey and the environmental data was assessed through systematic social observation by trained observers on street segments of respondents' residences. The relationship between environmental factors and LTPA was examined using multilevel logistic regression. The prevalence of LTPA was 30.2% (95% CI 27.4-32.9%). Individuals living in census tracts with higher walking environment indicators (OR = 1.20; 95% CI 1.02 to 1.40) and safety (OR = 1.18; 95% CI 1.01 to 1.38) were more likely to be active during leisure time, even after adjusting for individual variables. Improving the built and social environment is an important step for achieving higher levels of LTPA in the population in a middle-income country.

Contextual characteristics associated with the perceived neighbourhood scale in a cross-sectional study in a large urban centre in Brazil.

INTRODUCTION: Health outcomes have been associated with physical and social characteristics of neighbourhoods, but little is known about the relationship between contextual factors and perceived neighbourhood scale. OBJECTIVE: To identify the contextual factors associated with self-perceived neighbourhood scale. METHODS: We analysed data from a cross-sectional population-based study in Belo Horizonte, Brazil, that took place in 2008-2009. The dependent variable was perceived neighbourhood, encoded as an ordinal scale based on a brief description of the concept of the neighbourhood, and two independent scales relating distance, expressed in terms of geography and time. Street connectivity, demographic density and residents' perceptions of the neighbourhoods' physical and social environment were used as contextual predictors. Individual characteristics were used as covariates. Multilevel ordinal logistic regression models estimated the association between perceived neighbourhood scale and contextual characteristics. RESULTS: Residents that perceive better walkability (OR 2.96; 95% CI 1.29 to 3.82) and high amounts of violence (OR 1.35; 95% CI 1.12 to 1.62) perceived their neighbourhoods to be larger, even after adjusting for individual characteristics. CONCLUSION: There are contextual factors that are associated with self-perceived neighbourhood scale. Careful definition of neighbourhood scale is a key factor in improving the results of eco-epidemiological studies. Although these findings must be further explored in other studies, these results can contribute to a better understanding of an appropriate choice of neighbourhood scale, especially for cities in Latin America.

The Influence of Neighborhood Social Capital on Leisure-Time Physical Activity: a Population-Based Study in Brazil.

Environmentally targeted approaches to promote physical activity are emerging in recent years as a complementary strategy to the traditional individual approaches. This study explored the relation between community social capital and leisure-time physical activity in an adult population-based sample in Brazil. We applied a generalized estimating equation approach to analyze a cross-sectional survey of 3667 adults living in 149 neighborhoods. Social capital was assessed by scales that measured collective efficacy and social cohesion in the neighborhood. We find that individuals living in areas with higher level of social cohesion were more likely to be physically active even after controlling for potentially confounding individual and area-level covariates (PR = 1.56; 95% CI = 1.13, 2.16). Collective efficacy was not significantly associated with leisure-time physical activity. Interventions to strengthen social cohesion in the community may be an avenue for promoting physical activity.

Neighborhood-based physical activity differences: Evaluation of the effect of health promotion program.

INTRODUCTION: The practice of physical activity is an important factor in the prevention of health problems. However, a small portion of the population is physically active. Recent reviews show that physical activity classes in community settings have the potential to increase population levels of physical activity and reduce health inequalities. OBJECTIVE: To evaluate the effect of the Academias da Cidade Program in Belo Horizonte on the practice of physical activity in leisure time (PALT) by non-users living near the program centers. METHODS: We conducted a home-based health survey in Belo Horizonte (2008-2009) with 1,581 adults who were non-users of the program and who lived within a 1,500-meter radius of one active program center (exposed group) and two nonoperational centers with sites reserved for their construction (unexposed group). We collected data on PALT levels (≥150 minutes/week), which was measured with the Physical Activity International Questionnaire and analyzed with binary logistic regression using the Generalized Estimating Equations method. The propensity score was used as an adjustment variable to control the potential confusion in the measures of effect of exposure studied. RESULTS: The overall prevalence of the PALT was 26.5% in the exposed group and 22.7% in the unexposed group. The exposed group was more likely to be active in leisure time (OR = 1.05; CI 95%: 1.01-1.10). When considering the interaction between exposed group and distance, individuals in the exposed group who lived less than 500 meters from the program center were more likely to be active in leisure time (OR = 1.18, CI 95%: 1.03-1.35) compared to their counterparts. CONCLUSION: Promoting physical activity in the community can favorably affect PALT levels among residents, especially those living closest to intervention centers. We believe the Academias da Cidade Program is a promising strategy to facilitate the access to appropriate spaces for the practice of physical activity and contribute to increase the levels physical activity within populations.

Dirigir moto ou carro entre adolescentes: inquérito "saúde em Vespasiano", 2015 / Adolescents driving motorcycles or cars: inquiry "health in Vespasiano", 2015

INTRODUÇÃO: Inquérito de base populacional realizado em Vespasiano, Minas Gerais, em 2015/2016. Adolescentes e não habilitados para uso de veículos motorizados, representam maior risco para acidentes no trânsito. OBJETIVOS: Analisar o relato de frequência de dirigir moto e carro alguma vez na vida por adolescentes, bem como fatores associados a esse evento. MÉTODOS: Participaram 424 adolescentes com idades entre 11 e 17 anos, selecionados em amostra aleatória. Foram calculadas as frequências do relato de dirigir moto e carro alguma vez na vida associadas às variáveis explicativas bem como odds ratio, e seu intervalo de confiança a 95% Para análise, foi utilizado o software SPSS, versão 19.0. RESULTADOS: 26,4% dos adolescentes relataram ter dirigido moto e 23,6% ter dirigido carro alguma vez na vida. Na faixa etária de 14 a 17 anos observou-se frequência maior de relato de ter dirigido moto (78,6%) e carro (81,0%) comparados à faixa de 11 a 13 anos (21,4% e 19,0% respectivamente. Adolescentes que ingeriram bebida alcoólica alguma vez na vida apresentaram 2,9 vezes mais chance de relatar ter dirigido moto (IC 95% 1,8 - 4,6) e 2,7 vezes mais chance de relatar ter dirigido carro alguma vez na vida (IC 95% 1,7 - 4,3). 13,9% dos adolescentes relataram ter sofrido acidente de trânsito durante a vida, como motorista, passageiro ou pedestre. CONCLUSÕES: Em Vespasiano, 26,4% dos adolescentes estudados relataram ter dirigido moto e 23,6% carro, o que reforça a necessidade de maior reflexão quanto a estratégias preventivas à ocorrência da transgressão da lei de trânsito pelos adolescentes.(AU)

Introduction: Population based survey conducted in Vespasiano City, Minas Gerais State, Brasil, em 2015/2016. Young unlicensed drivers are more likely to adopt several inappropriate behaviors while driving. Objectives: determine and quantify the association between driving motorcycle and car sometime in life and selected explanatory variables. Methods: 424 teenagers aged 11-17 years were selected in a household random sample of census tracts. The frequency driving a motorcycle and/or car was calculated. Associations were quantified through the odds ratio and its 95% confidence interval. For the analysis we used the software SPSS, 19.0 version. Results: 26.4% of adolescents reported driving motorcycle and 23.6% have driven car sometime in life. The age group 14-17 years reported the a higher frequency of driving motorcycle (78.6%) and car (81%) compared to the age group 11 to 13 years (21.4% and 19%, respectively). Teens who used alcohol in their lifetime were 2.9 (CI 95% 1.8 ­ 4.6) times more likely to ride motorcycle and 2.7 (CI 95% 1.7 ­ 4.3) times more likely to drive a car; 13.9% of adolescents reported having suffered a traffic accident during life as a driver, passanger or pedestrian. Conclusions: In Vespasiano, 26.4% of adolescents reported having driven motorcycle and 23.6% have driven car. This result may contribute to discussion and preventive strategies for health and safety actions related to the occurrence of the violation of the traffic law by adolescents.(AU)

Socioeconomic position and disability: "The Belo Horizonte, Brazil Health Study". / Posição socioeconômica e deficiência: "Estudo Saúde em Belo Horizonte, Brasil".

This study aims to investigate the association of socioeconomic status and comorbidities of self-reported disability. Data were obtained from a population survey in Belo Horizonte from 2008 to 2009. The sample was probabilistic and stratified by conglomerates in three stages: census tracts, households and individuals. The outcome variable was disability, defined by the self-reported problems in bodily functions or structures. The explanatory variables were gender, age, self-reported morbidity and socioeconomic status index that included variables mother and respondent schooling and household income. The factorial analysis was used to evaluate the socioeconomic status index and logistic regression. The prevalence of disability was 10.43% (95% CI: 9.1-11.7%). Self-reported disability was associated with age (OR = 1.02; 95% CI: 1.01-1.03) and reporting of two or more diseases (OR = 3.24; CI 95%; 2.16-4.86) and socioeconomic status index (OR = 0.96; 95% CI: 0.95-0.97). The worse socioeconomic status and occurrence of diseases appear to contribute to the occurrence of disability. These results show health inequities among people with disabilities, and BPC relevance supporting vulnerable populations.

O objetivo deste estudo é investigar a associação da posição socioeconômica e comorbidades com o autorrelato da deficiência. Dados provenientes de inquérito populacional em Belo Horizonte, entre 2008 e 2009. Amostragem foi probabilística, estratificada por conglomerados em três estágios: setor censitário, domicílio e indivíduos. A variável resposta foi deficiência, definida a partir do autorrelato de problemas nas funções ou nas estruturas do corpo. As variáveis explicativas foram: sexo, idade, morbidade referida e índice da posição socioeconômica que incluiu variáveis de escolaridade materna, do entrevistado e renda familiar. Empregou-se a análise fatorial para avaliar a composição do índice da posição socioeconômica e análise de regressão logística. A prevalência de deficiência foi de 10,43%. O autorrelato de deficiência associou-se à idade (OR = 1,02; IC 95%: 1,01-1,03), ao relato de duas ou mais doenças (OR = 3,24; 2,16-4,86) e ao índice da posição socioeconômica (OR = 0,96; IC 95%: 0,95-0,97). A pior posição socioeconômica e a ocorrência de doenças parecem contribuir para a ocorrência de deficiência. Esses resultados evidenciam as iniquidades em saúde entre as pessoas com deficiência e a relevância do BPC no atendimento a populações vulneráveis.

Family context and the physical activity of adolescents: comparing differences. / Contexto familiar e atividade física de adolescentes: cotejando diferenças.

INTRODUCTION: Family context plays an important role with regard to the physical activity (PA) of adolescents. Intense changes in family composition, including an increase of single-parent structures can affect behavior. OBJECTIVE: To estimate the prevalence of PA, between boys and girls of 11-17 years old, and investigate its association with family context variables. METHODS: A cross-sectional population-based study "The BH Health Study" was conducted in two health districts of Belo Horizonte. The outcome was PA (≥ 300 minutes/week), which was created from a score that combined time and frequency of cycling and walking to school and leisure time. The independent variables were family context, sociodemographic characteristics and nutritional status. Poisson regression was used with a robust variance and was stratified by gender. RESULTS: 1,015 adolescents participated, 52.8% of whom were male, with a mean age of 14 (± 1.9) years old. The prevalence of PA was 38.8% for girls and 54.5% for boys. Among girls, the family context variables were not significantly associated with PA. Boys were more active when there was an adult in the household reported who did PA (PR = 1.26; 95%CI 1.02 - 1.55) and when living with a single mother (PR = 1.63; 95%CI 1.01 - 2.63). It was also observed that boys that live with their mother and father (PR=1.90; 95%CI 1.06 - 3.41) or only with their mother (PR = 1.82; 95%CI 1.01 - 3.27) reported did PA more frequently in their free time. CONCLUSION: The presence of an active adult in the household, mainly the mother, appears to be an important factor associated with boys' PA.

INTRODUÇÃO: O contexto familiar desempenha papel importante sobre a prática de atividade física (AF) de adolescentes. As intensas mudanças na composição familiar, com aumento das estruturas monoparentais, podem modular de maneira distinta esse comportamento. OBJETIVO: Estimar a prevalência de AF e associação da sua prática em meninos e meninas de 11 a 17 anos com variáveis de contexto familiar, ajustado por características sociodemográficas e estado nutricional. MÉTODOS: Estudo transversal de base populacional, denominado "Saúde em Beagá", realizado em dois distritos sanitários de Belo Horizonte. O desfecho foi AF ≥ 300 minutos/semana, criado a partir de um escore que combinou tempo e frequência de deslocamento para a escola e AF de lazer. As variáveis do contexto familiar foram: presença dos pais e de adulto ativo no domicílio. Foi utilizada regressão de Poisson com variância robusta, estratificada por sexo. RESULTADOS: Participaram 1.015 adolescentes, sendo 52,8% meninos e idade média de 14 (± 1,9) anos. A prevalência de AF foi de 38,8% para meninas e de 54,5% para meninos. Entre meninas, as variáveis de contexto familiar não foram significativamente associadas à AF. Meninos foram mais ativos quando havia um adulto no domicílio que praticava AF (RP = 1,26; IC95% 1,02 - 1,55) e quando moravam somente com a mãe (RP = 1,63; IC95% 1,01 - 2,63). Observou-se, ainda, que meninos que moravam com mãe e pai (RP = 1,90; IC95% 1,06 - 3,41) ou somente com mãe (RP = 1,82; IC95% 1,01 - 3,27) praticavam em maior frequência AF no seu tempo de lazer. CONCLUSÃO: A presença de adulto no domicílio, em especial a mãe, parece ser importante fator associado à prática de AF de meninos.

Posição socioeconômica e deficiência: "Estudo Saúde em Belo Horizonte, Brasil" / Socioeconomic position and disability: "The Belo Horizonte, Brazil Health Study"

Resumo O objetivo deste estudo é investigar a associação da posição socioeconômica e comorbidades com o autorrelato da deficiência. Dados provenientes de inquérito populacional em Belo Horizonte, entre 2008 e 2009. Amostragem foi probabilística, estratificada por conglomerados em três estágios: setor censitário, domicílio e indivíduos. A variável resposta foi deficiência, definida a partir do autorrelato de problemas nas funções ou nas estruturas do corpo. As variáveis explicativas foram: sexo, idade, morbidade referida e índice da posição socioeconômica que incluiu variáveis de escolaridade materna, do entrevistado e renda familiar. Empregou-se a análise fatorial para avaliar a composição do índice da posição socioeconômica e análise de regressão logística. A prevalência de deficiência foi de 10,43%. O autorrelato de deficiência associou-se à idade (OR = 1,02; IC 95%: 1,01-1,03), ao relato de duas ou mais doenças (OR = 3,24; 2,16-4,86) e ao índice da posição socioeconômica (OR = 0,96; IC 95%: 0,95-0,97). A pior posição socioeconômica e a ocorrência de doenças parecem contribuir para a ocorrência de deficiência. Esses resultados evidenciam as iniquidades em saúde entre as pessoas com deficiência e a relevância do BPC no atendimento a populações vulneráveis.

Abstract This study aims to investigate the association of socioeconomic status and comorbidities of self-reported disability. Data were obtained from a population survey in Belo Horizonte from 2008 to 2009. The sample was probabilistic and stratified by conglomerates in three stages: census tracts, households and individuals. The outcome variable was disability, defined by the self-reported problems in bodily functions or structures. The explanatory variables were gender, age, self-reported morbidity and socioeconomic status index that included variables mother and respondent schooling and household income. The factorial analysis was used to evaluate the socioeconomic status index and logistic regression. The prevalence of disability was 10.43% (95% CI: 9.1-11.7%). Self-reported disability was associated with age (OR = 1.02; 95% CI: 1.01-1.03) and reporting of two or more diseases (OR = 3.24; CI 95%; 2.16-4.86) and socioeconomic status index (OR = 0.96; 95% CI: 0.95-0.97). The worse socioeconomic status and occurrence of diseases appear to contribute to the occurrence of disability. These results show health inequities among people with disabilities, and BPC relevance supporting vulnerable populations.

Contexto familiar e atividade física de adolescentes: cotejando diferenças / Family context and the physical activity of adolescents: comparing differences

RESUMO: Introdução: O contexto familiar desempenha papel importante sobre a prática de atividade física (AF) de adolescentes. As intensas mudanças na composição familiar, com aumento das estruturas monoparentais, podem modular de maneira distinta esse comportamento. Objetivo: Estimar a prevalência de AF e associação da sua prática em meninos e meninas de 11 a 17 anos com variáveis de contexto familiar, ajustado por características sociodemográficas e estado nutricional. Métodos: Estudo transversal de base populacional, denominado "Saúde em Beagá", realizado em dois distritos sanitários de Belo Horizonte. O desfecho foi AF ≥ 300 minutos/semana, criado a partir de um escore que combinou tempo e frequência de deslocamento para a escola e AF de lazer. As variáveis do contexto familiar foram: presença dos pais e de adulto ativo no domicílio. Foi utilizada regressão de Poisson com variância robusta, estratificada por sexo. Resultados: Participaram 1.015 adolescentes, sendo 52,8% meninos e idade média de 14 (± 1,9) anos. A prevalência de AF foi de 38,8% para meninas e de 54,5% para meninos. Entre meninas, as variáveis de contexto familiar não foram significativamente associadas à AF. Meninos foram mais ativos quando havia um adulto no domicílio que praticava AF (RP = 1,26; IC95% 1,02 - 1,55) e quando moravam somente com a mãe (RP = 1,63; IC95% 1,01 - 2,63). Observou-se, ainda, que meninos que moravam com mãe e pai (RP = 1,90; IC95% 1,06 - 3,41) ou somente com mãe (RP = 1,82; IC95% 1,01 - 3,27) praticavam em maior frequência AF no seu tempo de lazer. Conclusão: A presença de adulto no domicílio, em especial a mãe, parece ser importante fator associado à prática de AF de meninos.

ABSTRACT: Introduction: Family context plays an important role with regard to the physical activity (PA) of adolescents. Intense changes in family composition, including an increase of single-parent structures can affect behavior. Objective: To estimate the prevalence of PA, between boys and girls of 11-17 years old, and investigate its association with family context variables. Methods: A cross-sectional population-based study "The BH Health Study" was conducted in two health districts of Belo Horizonte. The outcome was PA (≥ 300 minutes/week), which was created from a score that combined time and frequency of cycling and walking to school and leisure time. The independent variables were family context, sociodemographic characteristics and nutritional status. Poisson regression was used with a robust variance and was stratified by gender. Results: 1,015 adolescents participated, 52.8% of whom were male, with a mean age of 14 (± 1.9) years old. The prevalence of PA was 38.8% for girls and 54.5% for boys. Among girls, the family context variables were not significantly associated with PA. Boys were more active when there was an adult in the household reported who did PA (PR = 1.26; 95%CI 1.02 - 1.55) and when living with a single mother (PR = 1.63; 95%CI 1.01 - 2.63). It was also observed that boys that live with their mother and father (PR=1.90; 95%CI 1.06 - 3.41) or only with their mother (PR = 1.82; 95%CI 1.01 - 3.27) reported did PA more frequently in their free time. Conclusion: The presence of an active adult in the household, mainly the mother, appears to be an important factor associated with boys' PA.

[Indicators of physical and social neighborhood attributes measured by the Systematic Social Observation method]. / Indicadores dos atributos físicos e sociais da vizinhança obtidos pelo método de Observação Social Sistemática.

Place of residence is heavily shaped by social position, indicating that neighborhood characteristics can be important contributing factors to health iniquities. The objectives were to construct indicators of the physical and social environment in an urban context based on variables obtained with the Systematic Social Observation method (SSO) and to analyze them according to the Health Vulnerability Index (HVI). The instrument was developed to determine the characteristics of the physical and social neighborhood in two health districts in Belo Horizonte, Minas Gerais State, Brazil. Data were collected from April to June 2011. To develop the simple indicators, ratios were calculated for the number of observed items per residence in each segment. Composite indicators were built using principal components analysis via covariance matrix. The final sample consisted of 1,295 street segments nested in 147 neighborhoods. Indicators referring to street conditions and transit items, mobility, appearance, housing and property, physical disorder, safety/security, and services showed a dose-response behavior in relation to HVI (p < 0.05). Indicators pertaining to place to practice physical activity and leisure did not show significant differences. The indicators displayed coherent behavior towards different HVI strata and proved adequate within each respective domain and subdomain.

Indicadores dos atributos físicos e sociais da vizinhança obtidos pelo método de Observação Social Sistemática / Indicators of physical and social neighborhood attributes measured by the Systematic Social Observation method / Indicadores sobre el ambiente físico y social de un vecindario obtenidos por el método de la Observación Social Sistemática

Resumo: O local de moradia é fortemente modelado pela posição social, indicando que características da vizinhança podem ser importantes contribuintes para as iniquidades em saúde. O objetivo foi construir indicadores do ambiente físico e social em um contexto urbano a partir das variáveis obtidas pelo método de Observação Social Sistemática (OSS) e analisá-los de acordo com o Índice de Vulnerabilidade à Saúde (IVS). O instrumento foi desenvolvido com o objetivo de conhecer as características do entorno físico e social do local de moradia de residentes de dois distritos sanitários de Belo Horizonte, Minas Gerais, Brasil. Os dados foram coletados entre os meses de abril e junho de 2011. Na construção dos indicadores simples, foram calculadas razões do número de itens observados por residência para cada segmento. Na construção dos indicadores compostos, foi utilizado o método de análise de componentes principais via matriz de covariâncias. A amostra final foi composta por 1.295 segmentos de ruas aninhados em 147 vizinhanças. Percebemos que os indicadores referentes às condições das ruas e itens de trânsito, mobilidade, estético, caracterização dos imóveis, desordem física, segurança e serviços apresentaram um comportamento dose-resposta em relação ao IVS (valor de p < 0,05). Os indicadores referentes ao local para prática de atividade física e lazer não apresentaram diferenças significativas. Os indicadores demonstraram comportamento coerente diante de diferentes estratos do índice de vulnerabilidade da saúde e mostraram-se adequados dentro de cada domínio e subdomínio criados.

Abstract: Place of residence is heavily shaped by social position, indicating that neighborhood characteristics can be important contributing factors to health iniquities. The objectives were to construct indicators of the physical and social environment in an urban context based on variables obtained with the Systematic Social Observation method (SSO) and to analyze them according to the Health Vulnerability Index (HVI). The instrument was developed to determine the characteristics of the physical and social neighborhood in two health districts in Belo Horizonte, Minas Gerais State, Brazil. Data were collected from April to June 2011. To develop the simple indicators, ratios were calculated for the number of observed items per residence in each segment. Composite indicators were built using principal components analysis via covariance matrix. The final sample consisted of 1,295 street segments nested in 147 neighborhoods. Indicators referring to street conditions and transit items, mobility, appearance, housing and property, physical disorder, safety/security, and services showed a dose-response behavior in relation to HVI (p < 0.05). Indicators pertaining to place to practice physical activity and leisure did not show significant differences. The indicators displayed coherent behavior towards different HVI strata and proved adequate within each respective domain and subdomain.

Resumen: El lugar de residencia está fuertemente modelado por la posición social, indicando qué características del vecindario pueden contribuir de forma importante a las inequidades en salud. El objetivo de este estudio fue construir indicadores del ambiente físico y social en un contexto urbano, a partir de las variables obtenidas por el método de Observación Social Sistemática (OSS) y analizarlos de acuerdo con el Índice de Vulnerabilidad de la Salud (IVS). El instrumento se desarrolló con el objetivo de conocer las características del entorno físico y social del lugar de residencia de los habitantes de dos distritos sanitarios de Belo Horizonte, Minas Gerais, Brasil. Los datos se recogieron entre los meses de abril y junio de 2011. En la construcción de los indicadores simples, se calcularon las ratios del número de ítems observados por residencia para cada segmento. En la construcción de los indicadores compuestos, se utilizó el método del análisis de componentes principales vía matriz de covariancias. La muestra final estuvo compuesta por 1.295 segmentos de calles anidados en 147 vecindarios. Percibimos que los indicadores, referentes a las condiciones de las calles y elementos de tránsito, movilidad, estético, caracterización de los inmuebles, desorden físico, seguridad y servicios presentaron un comportamiento dosis-respuesta en relación con el IVS (valor de p < 0,05). Los indicadores concernientes al lugar para la práctica de la actividad física y ocio no presentaron diferencias significativas. Los indicadores demostraron un comportamiento coherente ante diferentes estratos del índice de vulnerabilidad de la salud y se mostraron adecuados dentro de cada dominio y subdominio creados.