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

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

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

Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil.

OBJECTIVE: This study monitors trends in access to cancer screening, focusing on mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA), assessing the magnitude of inequality in the city of São Paulo from 2003 to 2015 according to education level. METHOD: This is a cross-sectional population-based study conducted with data from the 2003, 2008, and 2015 editions of the Health Survey of the City of São Paulo (ISA-Capital). Outcome variables were the proportion of mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA) tests according to the protocols. Inequality was measured by education level according to years of study. For static analysis, Poisson regression was used to estimate proportion ratios. RESULTS: The proportion of Pap smears remained stationary at a high level (>89%) throughout the study period, while access to mammography and PSA tests significantly increased in the 2003‒2015 period. The present results indicate inequalities in access to cancer screening due to education, and being more expressive for mammography and PSA tests. However, this inequality significantly decreased over the period analyzed comparing the most educated individuals with those with the lowest educational level. In addition, an increase in the proportion of tests performed in the Brazilian Unified Health System was identified, especially for mammography and PSA tests, in the period 2003‒2015. CONCLUSIONS: The inequalities observed in the access to preventive exams were influenced by the level of education. The offer of exams was expanded, more significantly for mammography and PSA, especially among the less educated group.

Prevalence of body weight dissatisfaction among adolescents: a systematic review / Prevalência de insatisfação com o peso corporal entre adolescentes: uma revisão sistemática

ABSTRACT Objective: To identify the prevalence of weight dissatisfaction among adolescents aged 10-19 years and stratify the analysis by sex. Data source: A literature review of cross-sectional studies among healthy adolescents was performed. The U.S. National Library of Medicine/National Institutes of Health (PubMed), Ovid® (Wolters Kluwer), The Cumulative Index to Nursing and Allied Health Literature (CINAHL), and American Psychological Association (PsycINFO®) databases were searched between May 2019 and January 2020. Data synthesis: Initially, 3,700 records were identified, and 10 papers were obtained through other sources. After the removal of duplicates, 1,732 records were screened based on the titles and abstracts, and 126 were preselected for full-text analysis. After the application of the eligibility criteria, 34 papers were included in the present review. The studies were published between 1997 and 2020. The sample size ranged from <150 to >103,000 adolescents. The prevalence of weight dissatisfaction ranged from 18.0 to 56.6% in both sexes (10.8-82.5% among boys and 19.2-83.8% among girls). Conclusions: Based on the findings of the present systematic review, the prevalence of weight dissatisfaction is high among adolescents, especially girls. Such information can contribute to the planning of health and education programs addressing the issue of weight in adolescents.

RESUMO Objetivo: Identificar as prevalências de insatisfação com o peso corporal em adolescentes de dez a 19 anos, segundo o sexo. Fontes de dados: Foram selecionados estudos transversais que descreviam as prevalências de insatisfação com o peso em adolescentes saudáveis, nos idiomas inglês, português e espanhol. Não foram estabelecidos limites para o ano de publicação ou país. Utilizaram-se as bases de dados US National Library of Medicine/National Institutes of Health (PubMed), Ovid® (Wolters Kluwer), The Cumulative Index to Nursing and Allied Health Literature (CINAHL) e American Psychological Association (PsycINFO®), entre maio de 2019 e janeiro de 2020. Síntese dos dados: Inicialmente identificaram-se 3.700 registros e dez estudos em outras fontes de dados. Após a remoção dos estudos duplicados, foram rastreados 1.732 registros para a leitura de títulos e resumos, dos quais 126 artigos foram selecionados para avaliação do texto completo. Por fim, foi incluído nesta pesquisa o total de 34 artigos. Os estudos foram publicados entre 1997 e 2020. Os tamanhos amostrais variaram de <150 a >103.000 adolescentes. As prevalências de insatisfação com o peso variaram de 18,0 a 56,6% em ambos os sexos (10,8 a 82,5% no sexo masculino e 19,2 a 83,8% no feminino). Conclusões: Esta revisão identificou elevada prevalência de insatisfação com o peso corporal em adolescentes, superior em meninas. Tais informações podem contribuir para o planejamento de programas de saúde e educação direcionados à questão do peso em adolescentes.

Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil

Abstract Objective: This study monitors trends in access to cancer screening, focusing on mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA), assessing the magnitude of inequality in the city of São Paulo from 2003 to 2015 according to education level. Method: This is a cross-sectional population-based study conducted with data from the 2003, 2008, and 2015 editions of the Health Survey of the City of São Paulo (ISA-Capital). Outcome variables were the proportion of mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA) tests according to the protocols. Inequality was measured by education level according to years of study. For static analysis, Poisson regression was used to estimate proportion ratios. Results: The proportion of Pap smears remained stationary at a high level (>89%) throughout the study period, while access to mammography and PSA tests significantly increased in the 2003-2015 period. The present results indicate inequalities in access to cancer screening due to education, and being more expressive for mammography and PSA tests. However, this inequality significantly decreased over the period analyzed comparing the most educated individuals with those with the lowest educational level. In addition, an increase in the proportion of tests performed in the Brazilian Unified Health System was identified, especially for mammography and PSA tests, in the period 2003-2015. Conclusions: The inequalities observed in the access to preventive exams were influenced by the level of education. The offer of exams was expanded, more significantly for mammography and PSA, especially among the less educated group.

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

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

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

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

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

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

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

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

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

Prevalence of body weight dissatisfaction among adolescents: a systematic review.

OBJECTIVE: To identify the prevalence of weight dissatisfaction among adolescents aged 10-19 years and stratify the analysis by sex. DATA SOURCE: A literature review of cross-sectional studies among healthy adolescents was performed. The U.S. National Library of Medicine/National Institutes of Health (PubMed), Ovid® (Wolters Kluwer), The Cumulative Index to Nursing and Allied Health Literature (CINAHL), and American Psychological Association (PsycINFO®) databases were searched between May 2019 and January 2020. DATA SYNTHESIS: Initially, 3,700 records were identified, and 10 papers were obtained through other sources. After the removal of duplicates, 1,732 records were screened based on the titles and abstracts, and 126 were preselected for full-text analysis. After the application of the eligibility criteria, 34 papers were included in the present review. The studies were published between 1997 and 2020. The sample size ranged from <150 to >103,000 adolescents. The prevalence of weight dissatisfaction ranged from 18.0 to 56.6% in both sexes (10.8-82.5% among boys and 19.2-83.8% among girls). CONCLUSIONS: Based on the findings of the present systematic review, the prevalence of weight dissatisfaction is high among adolescents, especially girls. Such information can contribute to the planning of health and education programs addressing the issue of weight in adolescents.

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

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

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

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

Diet quality among older adults: What the Index Associated with the Digital Food Guide and the Brazilian Healthy Eating Index-Revised Reveal. / O que revela o Índice de Qualidade da Dieta associado ao Guia Alimentar Digital comparativamente a outro índice, em idosos?

The aim of the present study was to compare the Diet Quality Index-Digital Food Guide (DQI-DFG) to a more widely used measure in the literature: the Brazilian Healthy Eating Index-Revised (BHEI-R). A cross-sectional population-based study was conducted with 822 older adults (≥ 60 years) from the city of Campinas/SP, Brazil. The BHEI-R resulted in a higher overall score compared to DQI-DFG (62.9 vs. 47.7). For the BHEI-R, mean scores increased with age and were worse among smokers and individuals with a higher level of schooling. Regarding the DQI-DFG scores, no significant associations with age, schooling or smoking were detected; however, scores were higher in higher income segments. The components with the worst scores were whole grains, sodium and milk (BHEI-R); fruits, whole grains, roots/tubers, milk, refined cereals and red meat/processed (DQI-DFG). Divergences were found in the global scores and components of the indicators, reflecting important methodological differences. Studies of this nature constitute an opportunity to increase awareness regarding indicators of particular aspects of diet.

Objetivou-se avaliar o Índice de Qualidade da Dieta associado ao Guia Alimentar Digital (IQD-GAD) em comparação a outro mais utilizado e difundido na literatura, o Índice de Qualidade da Dieta Revisado (IQD-R). Estudo transversal de base populacional, com 822 idosos (≥ 60 anos) de Campinas, São Paulo. Utilizaram-se dados de um recordatório de 24 horas para efetuar os indicadores, cujas pontuações globais variam de zero a cem: quanto maior, melhor é a qualidade. Regressão linear simples e múltipla foi aplicada nas análises. O IQD-R resultou em maior pontuação global do que o IQD-GAD (62,9 vs. 47,5). No IQD-R, os escores médios foram melhores nos mais longevos e piores nos mais escolarizados e nos tabagistas. Quanto aos escores do IQD-GAD, não foram detectadas diferenças significativas em idade, escolaridade e tabagismo, mas foram maiores em segmentos de maior renda. Os componentes com piores pontuações: cereais integrais, sódio e leite (IQD-R); frutas, cereais integrais, raízes/tubérculos, leite, cereais refinados e carne vermelha/processada (IQD-GAD). Observaram-se discrepâncias nos escores globais e dos componentes dos indicadores, que refletem importantes diferenças metodológicas. Investigações dessa natureza configuram uma oportunidade de aprimorar a sensibilidade de indicadores a aspectos particulares da alimentação.

O que revela o Índice de Qualidade da Dieta associado ao Guia Alimentar Digital comparativamente a outro índice, em idosos? / Diet quality among older adults: What the Index Associated with the Digital Food Guide and the Brazilian Healthy Eating Index-Revised Reveal

Resumo Objetivou-se avaliar o Índice de Qualidade da Dieta associado ao Guia Alimentar Digital (IQD-GAD) em comparação a outro mais utilizado e difundido na literatura, o Índice de Qualidade da Dieta Revisado (IQD-R). Estudo transversal de base populacional, com 822 idosos (≥ 60 anos) de Campinas, São Paulo. Utilizaram-se dados de um recordatório de 24 horas para efetuar os indicadores, cujas pontuações globais variam de zero a cem: quanto maior, melhor é a qualidade. Regressão linear simples e múltipla foi aplicada nas análises. O IQD-R resultou em maior pontuação global do que o IQD-GAD (62,9 vs. 47,5). No IQD-R, os escores médios foram melhores nos mais longevos e piores nos mais escolarizados e nos tabagistas. Quanto aos escores do IQD-GAD, não foram detectadas diferenças significativas em idade, escolaridade e tabagismo, mas foram maiores em segmentos de maior renda. Os componentes com piores pontuações: cereais integrais, sódio e leite (IQD-R); frutas, cereais integrais, raízes/tubérculos, leite, cereais refinados e carne vermelha/processada (IQD-GAD). Observaram-se discrepâncias nos escores globais e dos componentes dos indicadores, que refletem importantes diferenças metodológicas. Investigações dessa natureza configuram uma oportunidade de aprimorar a sensibilidade de indicadores a aspectos particulares da alimentação.

Abstract The aim of the present study was to compare the Diet Quality Index-Digital Food Guide (DQI-DFG) to a more widely used measure in the literature: the Brazilian Healthy Eating Index-Revised (BHEI-R). A cross-sectional population-based study was conducted with 822 older adults (≥ 60 years) from the city of Campinas/SP, Brazil. The BHEI-R resulted in a higher overall score compared to DQI-DFG (62.9 vs. 47.7). For the BHEI-R, mean scores increased with age and were worse among smokers and individuals with a higher level of schooling. Regarding the DQI-DFG scores, no significant associations with age, schooling or smoking were detected; however, scores were higher in higher income segments. The components with the worst scores were whole grains, sodium and milk (BHEI-R); fruits, whole grains, roots/tubers, milk, refined cereals and red meat/processed (DQI-DFG). Divergences were found in the global scores and components of the indicators, reflecting important methodological differences. Studies of this nature constitute an opportunity to increase awareness regarding indicators of particular aspects of diet.

Social inequalities in the incidence, mortality, and survival of neoplasms in women from a municipality in Southeastern Brazil.

This study aims to analyze inequalities in the incidence, mortality, and survival of the main types of cancer in women according to the Social Vulnerability Index (SVI). The study was conducted in Campinas, São Paulo State, Brazil, from 2010 to 2014, and used data from the Population-based Cancer Registry and the Mortality Information System. Incidence and mortality rates standardized by age and 5-year survival estimates were calculated according to the social vulnerability strata (SVS), based on the São Paulo Social Vulnerability Index. Three SVS were delimited, with SVS1 being the lowest level of vulnerability and SVS3 being the highest. Rate ratios and the concentration index were calculated. The significance level was 5%. Women in SVS1 had a higher risk of breast cancer (0.46; 95%CI: 0.41; 0.51), colorectal cancer (0.56; 95%CI: 0.47; 0.68), and thyroid cancer (0.32; 95%CI: 0.26; 0.40), whereas women from SVS3 had a higher risk of cervical cancer (2.32; 95%CI: 1.63; 3.29). Women from SVS1 had higher mortality rates for breast (0.69; 95%CI: 0.53; 0.88) and colorectal cancer (0.69; 95%CI: 0.59; 0.80) and women from SVS3 had higher rates for cervical (2.35; 95%CI: 1.57; 3.52) and stomach cancer (1.43; 95%CI: 1.06; 1.91). Women of highest social vulnerability had lower survival rates for all types of cancer. The observed inequalities differed according to the location of the cancer and the analyzed indicator. Inequalities between incidence, mortality, and survival tend to revert and the latter is always unfavorable to the segment of highest vulnerability, indicating the existence of inequality in access to early diagnosis and timely treatment.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Social inequalities in the incidence, mortality, and survival of neoplasms in women from a municipality in Southeastern Brazil / Desigualdades sociais na incidência, mortalidade e sobrevida de câncer em mulheres em um município do Sudeste do Brasil / Inequidades sociales en la incidencia, mortalidad, y supervivencia relacionada con neoplasmas en mujeres de una municipalidad en el sudeste de Brasil

This study aims to analyze inequalities in the incidence, mortality, and survival of the main types of cancer in women according to the Social Vulnerability Index (SVI). The study was conducted in Campinas, São Paulo State, Brazil, from 2010 to 2014, and used data from the Population-based Cancer Registry and the Mortality Information System. Incidence and mortality rates standardized by age and 5-year survival estimates were calculated according to the social vulnerability strata (SVS), based on the São Paulo Social Vulnerability Index. Three SVS were delimited, with SVS1 being the lowest level of vulnerability and SVS3 being the highest. Rate ratios and the concentration index were calculated. The significance level was 5%. Women in SVS1 had a higher risk of breast cancer (0.46; 95%CI: 0.41; 0.51), colorectal cancer (0.56; 95%CI: 0.47; 0.68), and thyroid cancer (0.32; 95%CI: 0.26; 0.40), whereas women from SVS3 had a higher risk of cervical cancer (2.32; 95%CI: 1.63; 3.29). Women from SVS1 had higher mortality rates for breast (0.69; 95%CI: 0.53; 0.88) and colorectal cancer (0.69; 95%CI: 0.59; 0.80) and women from SVS3 had higher rates for cervical (2.35; 95%CI: 1.57; 3.52) and stomach cancer (1.43; 95%CI: 1.06; 1.91). Women of highest social vulnerability had lower survival rates for all types of cancer. The observed inequalities differed according to the location of the cancer and the analyzed indicator. Inequalities between incidence, mortality, and survival tend to revert and the latter is always unfavorable to the segment of highest vulnerability, indicating the existence of inequality in access to early diagnosis and timely treatment.

O estudo teve como objetivo analisar desigualdades na incidência, mortalidade e sobrevida de câncer em mulheres de acordo com o Índice de Vulnerabilidade Social (IVS). O estudo foi realizado em Campinas, Estado de São Paulo, Brasil, no período de 2010 a 2014 e usou dados do Registro de Câncer de Base Populacional (RCBP) e do Sistema de Informação de Mortalidade (SIM). Foram calculadas as taxas de incidência e mortalidade padronizadas por idade e estimativas de sobrevida em cinco anos de acordo com estratos de vulnerabilidade social. Foram demarcados três estratos com base no IVS de São Paulo, onde o estrato 1 representava o nível de menor vulnerabilidade e o estrato 3 o de maior vulnerabilidade. Foram calculadas razões de taxas e índice de concentração, com nível de significância de 5%. Foram encontrados riscos mais elevados de câncer de mama (0,46; IC95%: 0,41; 0,51), colorretal (0,56; IC95%: 0,47; 0,68) e tireoide (0,32; IC95%: 0,26; 0,40) em mulheres do estrato 1 e de colo uterino em mulheres do estrato 3 (2,32; IC95%: 1,63; 3,29). Mulheres do estrato 1 tiveram taxas mais elevadas de câncer de mama (0,69; IC95%: 0,53; 0,88) e colorretal (0,69; IC95%: 0,59; 0,80), e mulheres do estrato 3 tiveram taxas mais elevadas de câncer do colo uterino (2,35; IC95%: 1,57; 3,52) e estômago (1,43; IC95%: 1,06; 1,91). Para todos os tipos de câncer, a sobrevida era mais baixa em mulheres do estrato de maior vulnerabilidade social. As desigualdades observadas mostraram diferenças de acordo com a localização do tumor e o indicador utilizado. Além disso, há uma tendência de inverter as desigualdades entre incidência, mortalidade e sobrevida, onde a sobrevida sempre é desfavorável para o estrato de maior vulnerabilidade, indicando a existência de desigualdades em acesso ao diagnóstico precoce e tratamento precoce.

El objetivo fue analizar las inequidades en la incidencia, mortalidad y supervivencia de los principales tipos de cáncer en mujeres, según el Índice de Vulnerabilidad Social (IVS). El estudio se llevó a cabo en Campinas, estado de São Paulo, Brasil, durante el período 2010-2014, y se usaron datos del Registro de Cáncer de Base Poblacional (RCBP) y el Sistema de Información de Mortalidad (SIM). Las tasas de incidencia y mortalidad estandarizadas por edad, así como las estimaciones de supervivencia durante cinco años, se calcularon según los estratos de vulnerabilidad social (SVS). Se delimitaron tres SVS, basados en el IVS de São Paulo, con SVS1 siendo el nivel más bajo de vulnerabilidad y SVS3 siendo el nivel más alto de vulnerabilidad. Se calcularon los cocientes de tasas y el índice de concentración. El nivel de significancia fue 5%. Se encontró un riesgo más alto de cáncer de la mama (0,46; IC95%: 0,41; 0,51), colorrectal (0,56; IC95%: 0,47; 0,68), y tiroides (0,32; IC95%: 0,26; 0,40) en mujeres de SVS1, y cáncer cervical en mujeres de SVS3 (2,32; IC95%: 1,63; 3,29). Respecto a la mortalidad, las mujeres de SVS1 tuvieron tasas más altas en cáncer de la mama (0,69; IC95%: 0,53; 0,88) y colorrectal (0,69; IC95%: 0,59; 0,80) y las mujeres de SVS3 tuvieron tasas más altas en cáncer cervical (2,35; IC95%: 1,57; 3,52) y estómago (1,43; IC95%: 1,06; 1,91). Para todos los tipos de cáncer, las tasas de supervivencia fueron más bajas en mujeres del estrato social con más alta vulnerabilidad social. Las inequidades sociales observadas difirieron según la localización del cáncer y el indicador analizado, y no hubo una tendencia para revertir las inequidades entre incidencia, mortalidad y supervivencia, las últimas siempre fueron desfavorables para el segmento de más alta vulnerabilidad, indicando la existencia de desigualdad en el acceso a un diagnóstico temprano y un tratamiento oportuno.

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

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

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

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