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1.
Am J Public Health ; 111(4): 730-738, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33600255

RESUMO

Objectives. To analyze trends in cigarette smoking among Brazilian adults from 2006 to 2019.Methods. We performed a time-series analysis based on data from the Surveillance of Risk and Protective Factors for Chronic Diseases Telephone Survey (n = 730 309). We calculated the annual prevalence of current cigarette smokers, heavy smokers, and passive smokers in the workplace and investigated linear trends using Prais-Winsten regression, for the entire period and for the past 5 years. We performed the analyses for the total population and according to the sociodemographic characteristics.Results. The prevalence of cigarette smoking, heavy smoking, and passive smoking in the workplace declined, respectively, an average of 3.99% per year, 5.65% per year, and 6.55% per year from 2006 to 2019. We observed this reduction regardless of gender, age, educational level, and geographic region. The magnitude of reduction in the prevalence of current cigarette smoking decreased in the past 5 years, while the magnitude of the change in heavy smoking increased.Conclusions. The prevalence of cigarette smoking decreased in the time period studied. The smaller magnitude of reduction for current cigarette smoking in the most recent years might indicate a fatigue with the current policy scenario.


Assuntos
Fumar Cigarros , Fumantes/estatística & dados numéricos , Adulto , Distribuição por Idade , Brasil/epidemiologia , Fumar Cigarros/epidemiologia , Fumar Cigarros/tendências , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência , Fatores Sexuais , Abandono do Hábito de Fumar
2.
Rev Saude Publica ; 57: 17, 2023.
Artigo em Inglês, Português | MEDLINE | ID: mdl-37075400

RESUMO

OBJECTIVES: To estimate the prevalence of weekly, monthly and abusive alcohol consumption in Brazil in 2013 and 2019, compare the period estimates, and verify the magnitude of the differences. METHODS: Analysis of data on alcohol consumption in the adult population (18 years or older) from the National Health Survey (PNS), 2013 and 2019. The number of interviewees in 2013 was 60,202 and 88,531 in 2019. The samples were characterized according to demographic, socioeconomic, health, and alcohol consumption variables and differences in proportions in the period were compared using Pearson's c2 test, with Rao-Scott approximation and a 5% significance level. Multivariate Poisson regression models were estimated for the outcome variables of monthly, weekly and abusive consumption of alcoholic beverages, in order to estimate the magnitude of the differences between the 2013 and 2019 PNS estimates, using the prevalence ratio (PR). Models were adjusted per sex and age group and stratified per sex and demographic region. RESULTS: There was a difference in the distribution of the population according to race, occupation, income, age group, marital status, and education. There was an increase in alcohol consumption for all outcome variables, with the exception of weekly consumption in males. The PR of weekly consumption was 1.02 (95%CI 1.014-1.026), and in females the PR was 1.05 (95%CI 1.04-1.06). The highest PRs in the general population and per sex occur for abusive consumption. The increase in weekly consumption per region occurred in the South, Southeast, and Central-West regions. CONCLUSIONS: Males are the main alcohol consumers in Brazil; the PRs for both males and females show that there was an increase in monthly, weekly and abusive consumption in the research period; it is noteworthy that females have increased their consumption pattern with greater intensity than males.


Assuntos
Consumo de Bebidas Alcoólicas , Bebidas Alcoólicas , Adulto , Masculino , Feminino , Humanos , Fatores Socioeconômicos , Prevalência , Brasil/epidemiologia , Consumo de Bebidas Alcoólicas/epidemiologia
3.
Epidemiol Serv Saude ; 32(3): e2023313, 2023.
Artigo em Inglês, Português | MEDLINE | ID: mdl-38018647

RESUMO

OBJECTIVE: To analyze chronic kidney disease mortality in Brazil according to sex, age group and region of residence, from 2009 to 2020. METHODS: This was a time series study having deaths as its unit of analysis, based on Mortality Information System data. The mortality rate was standardized using the direct method and the temporal trend was analyzed using the Prais-Winsten method. RESULTS: There was a rising trend in chronic kidney disease mortality, ranging from 2.82, in 2009, to 3.24 in 2020 (average annual increase 1.29%; 95%CI 0.73;1.85), with a greater increase in males (1.14% per year; 95%CI 0.52;1.76), those aged 75 years and over (2.23% per year; 95%CI 1.87; 2.60) and in the Northern Region (3.86% per year; 95%CI 1.86;5.90) and Northeast Region (3.36% per year; 95%CI 2.24;4.50). CONCLUSION: Chronic kidney disease mortality showed a rising trend in the period, with sociodemographic disparities. MAIN RESULTS: A rising mortality trend was found for both sexes, with a greater increase in males, those aged over 75 years and in the North and Northeast regions of Brazil; mortality was highest in the Midwest region throughout the entire period. IMPLICATIONS FOR SERVICES: The results point to the need to implement public policies with guidelines for addressing chronic kidney disease, focused on strengthening Primary Health Care (PHC). PERSPECTIVES: Expanding access to health services, health education and integration between PHC, health surveillance and specialized care are strategies that would possibly prove to be efficient in managing this chronic health condition.


Assuntos
Mortalidade , Insuficiência Renal Crônica , Feminino , Humanos , Masculino , Brasil/epidemiologia , Sistemas de Informação , Insuficiência Renal Crônica/mortalidade , Mortalidade/tendências
4.
Epidemiol Serv Saude ; 31(spe1): e2021366, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35830016

RESUMO

OBJECTIVE: To describe the proportion of adults with hypertension and diabetes who obtained medication through the Brazilian Popular Pharmacy Program (Programa Farmácia Popular). METHOD: Population-based descriptive study, using data from the 2019 Brazilian National Health Survey. The proportion of individuals who obtained at least one type of medication for hypertension and diabetes in the Program was analysed according to socioeconomic and demographic characteristics, by regions and federative units. RESULTS: The proportion of individuals who obtained medication for hypertension was 45.1% (95%CI 43.7;46.5), and, for diabetes, 51.5% (95%CI 49.5;53.6). Respectively for both conditions, medication obtainment was higher in the South region (54.3%; 95%CI 51.3;57.2 and 59.1%; 95%CI 54.6;63.7) and lower in the higher strata level of education (30.9%; 95%CI 27.7;34.2 and 40.7%; 95%CI 35.1;46.3) and income (24.0%; 95%CI 19.7;28.2 and 28.9%; 95%CI 22.1;35.7). CONCLUSION: Regional and socioeconomic inequalities were identified in obtaining medication for hypertension and diabetes through the Program.


Assuntos
Diabetes Mellitus , Hipertensão , Farmácia , Adulto , Brasil , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/epidemiologia , Inquéritos Epidemiológicos , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia
5.
Epidemiol Serv Saude ; 31(spe1): e2021384, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35830090

RESUMO

OBJECTIVE: To describe the prevalence of self-reported depression among Brazilian adults in the 2019 National Health Survey (PNS) and compare to the 2013 PNS. METHODS: Cross-sectional study of Brazilian adults using data from the 2019 and 2013 PNS. Prevalence and 95% confidence intervals (95%CI) of self-reported depression were estimated by region and demographic characteristics. Bivariate analyses were conducted using chi-squared tests. RESULTS: There were 90,846 participants aged ≥ 18 years in 2019, and 60,202 in 2013. Between 2013 and 2019, prevalence of self-reported depression increased from 7.6% (95%CI 7.2;8.1) to 10.2% (95%CI 9.9;10.6) and of individuals who sought healthcare, from 46.4% (95%CI 43.8;49.1) to 52.8% (95%CI 50.7;55.0). Private clinics were the main source of healthcare. CONCLUSION: Depression is highly prevalent in Brazil. Prevalence of diagnosis of depression and use of health services increased in the studied period. The predominance of care in private clinics suggests inequalities in the improvement of mental healthcare coverage.


Assuntos
Depressão , Adulto , Brasil/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Inquéritos Epidemiológicos , Humanos , Prevalência , Autorrelato
6.
Cad Saude Publica ; 38Suppl 1(Suppl 1): e00125421, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35613254

RESUMO

This study compared indicators of care and access to health services by adults who self-reported hypertension in 2013 and 2019, analyzing those indicators according to gender, age group, schooling level, and race/color. This is an analytic study with data from the Brazilian National Health Survey (PNS), conducted in 2013 and 2019 in Brazil. The indicators to care and access to health services by individuals with arterial hypertension in both surveys were compared. For 2019, those indicators were analyzed according to sociodemographic characteristics. This study estimated the proportions, prevalence ratio (PR), and their respective 95% confidence intervals (95%CI). In total, 60,202 individuals were evaluated in 2013 and 88,531 in 2019, of these 24.4% reported arterial hypertension in 2013 and 23.9% in 2019. Women received more medical care for hypertension within the last year (PR = 1.07; 95%CI: 1.04; 1.11), had the last physician appointment at an basic health unit (PR = 1.11; 95%CI: 1.05; 1.17) than men. About race/color, black people had more hospitalization for hypertension or some complication (PR = 1.2; 95%CI: 1.05; 1.38) and intense or very intense degree of limitation in performing daily activities (PR = 1.37; 95%CI: 1.06; 1.76). In 2019, inequalities were evidenced and worse indicators were observed for males, black, with low education and young age. Therefore, investments in the Brazilian Unified National Health System, as well as public policies and strategic actions are essential to reduce inequalities, promote health care.


Assuntos
Promoção da Saúde , Hipertensão , Adulto , Brasil/epidemiologia , Feminino , Acessibilidade aos Serviços de Saúde , Inquéritos Epidemiológicos , Humanos , Hipertensão/epidemiologia , Masculino , Autorrelato , Fatores Socioeconômicos
7.
Epidemiol Serv Saude ; 31(spe1): e2021388, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35792797

RESUMO

OBJECTIVE: To describe the indicators of smoking cessation in 2013 and 2019 for Brazil and federative units, according to sociodemographic variables, collected in the National Health Survey (PNS). METHODS: Cross-sectional, population-based and descriptive study with data from the 2013 and 2019 PNS, a household survey collected by trained interviewers. The prevalence of ex-smokers and the proportion of smokers who tried to quit smoking in the 12 months prior to the interview, and respective confidence intervals (95%CI) were calculated, according to sociodemographic variables. Additionally, the percentage variation between the years was calculated. RESULTS: In 2013, the prevalence of ex-smokers was 17.5% (95%CI 16.9;18.0) and, in 2019, 26.6% (95%CI 26.1;27.2). In 2013, 51.1% tried to quit smoking (95%CI 49.3;52.9) and, in 2019, 46.6% (95%CI 45.0;48.3). CONCLUSION: It is important to strengthen and maintain strategies for coping with tobacco use in Brazil, to increase the current smoker's willingness and ability to quit smoking.


Assuntos
Abandono do Hábito de Fumar , Brasil/epidemiologia , Estudos Transversais , Inquéritos Epidemiológicos , Humanos , Fumar/epidemiologia
8.
Epidemiol Serv Saude ; 31(spe1): e2021364, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35830015

RESUMO

OBJECTIVE: To monitor the achievement of the action plans for the prevention and control of Non-Communicable Diseases agreed-upon targets. METHODS: Cross-sectional study, with data from the 2013 and 2019 National Health Survey. The following targets, up to 2025, were evaluated: physical inactivity, alcohol consumption, salt/sodium, tobacco use, high blood pressure, diabetes, overweight, obesity, cervical cytology testing, and drug therapy and counseling. To check whether the targets were achieved, the prevalence ratio was calculated (PR). RESULTS: 60,202 individuals were assessed in 2013, and 88,531 in 2019. The targets for physical inactivity (PR = 0.88; 95%CI 0.86;0.90) and cervical cytology coverage (79.4%; 95%CI 78.3;80.3) were achieved. Tobacco use was reduced, albeit below the target. The prevalence of hypertension, diabetes, overweight, obesity and alcohol consumption increased, and the targets will not be attained. CONCLUSION: Two indicators reached the agreed targets, however it is necessary to advance in actions and policies to meet the others.


Assuntos
Diabetes Mellitus , Hipertensão , Doenças não Transmissíveis , Adaptação Psicológica , Brasil/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Objetivos , Inquéritos Epidemiológicos , Humanos , Hipertensão/epidemiologia , Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/prevenção & controle , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Fatores de Risco
9.
Epidemiol Serv Saude ; 31(spe1): e2021369, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35946670

RESUMO

OBJECTIVE: To describe the prevalence of arterial hypertension according to sociodemographic characteristics in Brazil and to analyze the indicators related to access to health services and guidelines for controlling the disease in the country. METHODS: Cross-sectional descriptive study using the National Health Survey (PNS) conducted in 2019. The prevalence of hypertension was estimated with a 95% confidence interval, in addition to the proportions of hypertension indicators. RESULTS: There were 88,531 respondents, of which 23.9% self-reported hypertension, more prevalent among females (26.4%) and the elderly (55.0%). Among those who self-reported hypertension, 57.8% reported medical attention in the last six months; most received guidance on self-care; 66.1% were seen in public health services; and 45.8%, in primary health care units. CONCLUSION: The prevalence of hypertension in the Brazilian population was high, with most people who self-reported the condition being seen in services of the Brazilian National Health System (SUS), where they received guidance on health promotion.


Assuntos
Hipertensão , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Promoção da Saúde , Inquéritos Epidemiológicos , Humanos , Hipertensão/epidemiologia , Hipertensão/terapia , Autorrelato , Fatores Socioeconômicos
10.
Epidemiol Serv Saude ; 31(spe1): e2021382, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35946671

RESUMO

OBJECTIVE: To compare health care indicators for adults with medical diagnosis of diabetes mellitus (DM) in Brazil, in 2013 and 2019, and analyze the indicators for 2019 according to sociodemographic characteristics. METHODS: Cross-sectional study using data from the 2013 and 2019 National Health Survey. Care indicators were evaluated in people with medical diagnosis of DM. RESULTS: DM prevalence increased from 6.2% (2013) to 7.7% (2019). Between 2013 and 2019, there was an increase in the use of medications (from 80.2% to 88.8%) and of medical care (from 73.2% to 79.1%), a reduction in the use of Popular Pharmacy Program medications (from 57.4% to 51.5%) and in follow-up with the same physician (from 65.2% to 59.4%). In 2019, poorer indicators were observed for individuals who were male, younger, Black and Brown, and with lower education and income. CONCLUSION: Most indicators remained similar in the last five years, with differences according to sociodemographic characteristics in 2019.


Assuntos
Diabetes Mellitus , Adulto , Brasil/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Escolaridade , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino
11.
Cad Saude Publica ; 38Suppl 1(Suppl 1): e00164321, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35857956

RESUMO

Our objective is to describe the differences in the sampling plans of the two editions of the Brazilian National Health Survey (PNS 2013 and 2019) and to evaluate how the changes affected the coefficient of variation (CV) and the design effect (Deff) of some estimated indicators. Variables from different parts of the questionnaire were analyzed to cover proportions with different magnitudes. The prevalence of obesity was included in the analysis since anthropometry measurement in the 2019 survey was performed in a subsample. The value of the point estimate, CV, and the Deff were calculated for each indicator, considering the stratification of the primary sampling units, the weighting of the sampling units, and the clustering effect. The CV and the Deff were lower in the 2019 estimates for most indicators. Concerning the questionnaire indicators of all household members, the Deffs were high and reached values greater than 18 for having a health insurance plan. Regarding the indicators of the individual questionnaire, for the prevalence of obesity, the Deff ranged from 2.7 to 4.2, in 2013, and from 2.7 to 10.2, in 2019. The prevalence of hypertension and diabetes per Federative Unit had a higher CV and lower Deff. Expanding the sample size to meet the diverse health objectives and the high Deff are significant challenges for developing probabilistic household-based national survey. New probabilistic sampling strategies should be considered to reduce costs and clustering effects.


Assuntos
Obesidade , Brasil/epidemiologia , Análise por Conglomerados , Inquéritos Epidemiológicos , Humanos , Obesidade/epidemiologia , Tamanho da Amostra
12.
Rev Bras Epidemiol ; 24(suppl 2): e210012, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34910066

RESUMO

OBJECTIVE: to estimate the prevalence and factors associated with angina pectoris in the Brazilian adult population and per federated units. METHODS: Cross-sectional descriptive study that analyzed data from the National Survey of Health 2019 and assessed the prevalence of angina in the Brazilian population. Angina was defined as chest pain or discomfort when climbing hills or stairs, or when walking fast on flat terrain (angina I) or when walking at normal speed on flat terrain (angina II). Prevalence, crude and adjusted prevalence ratios were calculated, with a 95% confidence interval, according to sociodemographic characteristics (sex, age group, self-reported race/skin color and region of residence) and federative units. RESULTS: The prevalence of mild angina (grade I) was 8.1% and of moderate/severe angina (grade II) was 4.5%, being both more prevalent in women (9.8 and 5.5%, respectively). The prevalence increased progressively with age and was inversely proportional to years of formal study. Grade I angina was higher in individuals self-reportedly black and residents of Sergipe (10,4%). Angina II was more prevalent in people self-reportedly brown and living in Amazonas (6.3%). CONCLUSION: Angina affects more than 10% of the Brazilian population aged 18 years old and more, with higher prevalence in states in the North and Northeast. This is a problem that affects the most vulnerable populations unequally, which places coronary heart disease as a public health problem and points to the need to think about public policies aimed at these strata of the population.


Assuntos
Angina Pectoris , Adolescente , Adulto , Angina Pectoris/epidemiologia , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Prevalência , Autorrelato
13.
Rev Bras Epidemiol ; 24(suppl 2): e210002, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34910056

RESUMO

OBJECTIVE: Compare the demand and use of health services between 2013 and 2019, and analyze the associated sociodemographic and health variables in 2019. METHODS: Cross-sectional study with data from the National Health Survey (PNS) 2013 and 2019. The prevalence and 95% confidence intervals (95% CI) for the demand and use of health services were estimated. In 2019, the differences in the indicators were analyzed according to sociodemographic variables and the crude and adjusted by sex and age prevalence ratios (RP) were estimated. RESULTS: There was an increase of 22% in the demand for health care in the last two weeks, going from 15.3% (95%CI 15.0-15.7) in 2013 to 18.6% (95%CI 18.3-19.0) in 2019. There was a reduction in use in the last two weeks, from 97% (95%CI 96.6-97.4) in 2013 to 86.1% (95%CI 85.4-86.8) in 2019, which was observed for most Federation Units. In 2019, the demand for care was greater among women, the elderly, those with high schooling, individuals with health insurance and poor self-rated health. They obtained greater access to health services in the fifteen days prior to the survey: men, children or adolescents up to 17 years of age, people with health insurance and poor health self-assessment. CONCLUSION: The demand for health services has grown and reduced access in the last 15 days between 2013 and 2019. These differences may have been exacerbated by the austerity measures implemented in the country.


Assuntos
Acessibilidade aos Serviços de Saúde , Adolescente , Idoso , Brasil , Criança , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Fatores Socioeconômicos
14.
Rev Bras Epidemiol ; 24(suppl 2): e210008, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34910062

RESUMO

OBJECTIVE: The aim of this study was to analyze the prevalence of leisure-time physical activity in 2013 and 2019 according to sociodemographic characteristics in Brazilian adults. METHODS: We analyzed data from the National Health Surveys conducted in 2013 and 2019. Prevalence of leisure-time physical activity (150+ minutes per week in physical activities) was calculated according to gender, age, education, race/skin color, Federative Units, and regions of Brazil in 2013 and 2019. Poisson regression models and 95% confidence intervals (95%CI) were used to compare leisure-time physical activity across different groups in 2013 and 2019. RESULTS: The proportion of Brazilian adults active in leisure-time increased from 22.7% (95%CI 22.06-23.34) in 2013 to 30.1% (95%CI 29.44-30.67) in 2019. The prevalence of leisure-time physical activity increased between 2013 and 2019 in 23 of the 27 Federative Units in Brazil. Both in 2013 and in 2019, the proportion of active people during leisure time was higher in men, young people, with a high level of education and individuals with white skin color. Overall, the magnitude of the observed differences in leisure-time physical activity between sociodemographic groups slightly decreased from 2013 to 2019. CONCLUSIONS: Despite the increase in the prevalence of leisure-time physical activity among Brazilian adults in the last six years, marked sociodemographic inequalities persist. The success of future public policies to promote physical activity in leisure must be evaluated from the perspective of social determinants of health and the reduction of inequalities in the practice of physical activity.


Assuntos
Exercício Físico , Atividades de Lazer , Adolescente , Adulto , Brasil , Inquéritos Epidemiológicos , Humanos , Masculino , Fatores Socioeconômicos
15.
Rev Bras Epidemiol ; 24(suppl 2): e210017, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34910071

RESUMO

OBJECTIVE: To estimate prevalence of healthy behaviors among individuals aged 30 years or more, diagnosed with arterial hypertension and diabetes mellitus, using information from the National Health Survey, 2019. METHODS: Cross-sectional study with cluster sampling and simple random sampling in three stages. Individuals were aggregated according the following conditions: having arterial hypertension; arterial hypertension only; diabetes mellitus; diabetes mellitus only; arterial hypertension and diabetes mellitus only; without chronic non-communicable diseases. Poisson regression models and crude and adjusted prevalence ratios for sex, age group, and schooling were used. The proportion of recommendations received by patients with arterial hypertension and diabetes mellitus was estimated by type of care (public/private). RESULTS: A total of 69,285 individuals aged 30 years or more was analyzed. Compared to individuals without non-communicable diseases, prevalence of consumption of fruits and vegetables ≥5 days a week was significantly higher among individuals with arterial hypertension (39.9% - 95%CI 38.8-41.0) and those with diabetes mellitus (42.8% - 95%CI 40.7-44.9). However, estimates of not having consumed ultra-processed food were low, 19.7% (95%CI 18.9-20.6) and 21.9% (95%CI 20,3-23.5), respectively. Prevalence of not smoking reached values close to 90% and significant prevalence ratios, whereas the practice of physical activity had levels below 30% and non-significant prevalence ratios. The proportion of healthy eating recommendations reached 90%, but it was close to 70% for not smoking. CONCLUSIONS: It is necessary to encourage the practice of healthy lifestyles and provide information about the benefits of physical activity and the harmful effects of unhealthy eating for well-being and aging with quality.


Assuntos
Diabetes Mellitus , Hipertensão , Brasil/epidemiologia , Estudos Transversais , Atenção à Saúde , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Estilo de Vida Saudável , Humanos , Hipertensão/epidemiologia , Prevalência , Fatores de Risco
16.
Cien Saude Colet ; 26(suppl 1): 2515-2528, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34133631

RESUMO

This study aimed to investigate changes in the health service use pattern based on information from the 2013 and 2019 National Health Surveys (PNS). The two outcomes, "Seeking health-related care in the past two weeks" and "Medical visit in the last twelve months", were analyzed according to socioeconomic, geographic and health conditions characteristics. Multivariate Poisson regression models were used to investigate the factors associated with seeking care due to a health problem or prevention. The prevalence of chronic diseases increased from 15.0% to 22.5% between 2013 and 2019. The proportion of seeking care increased from 15.3 to 18.6%, and medical visits from 71.2% to 76.2%, ranging from 61.4 to 75.8% and 68.0 to 80.6% between the North and Southeast regions. There was no significant association of seeking care due to a health problem with per capita income, after controlling for the other covariates. We conclude by saying that, despite the expanded coverage of health service use, the persistent regional inequalities indicate unmet health needs among residents of the less developed regions. Health care models focused on prevention and health promotion are required.


Este estudo teve o objetivo de comparar os padrões de utilização de serviços de saúde, a partir das informações das edições da Pesquisa Nacional de Saúde (PNS), 2013 e 2019. Os dois desfechos "Procura de atendimento relacionado à saúde nas últimas duas semanas" e "Consulta médica nos últimos doze meses" foram analisados segundo fatores socioeconômicos, geográficos, e condições de saúde. Foram usados modelos multivariados de regressão de Poisson para investigar os fatores associados à procura de atendimento de acordo com o motivo (problema de saúde ou prevenção). Entre 2013 e 2019, a prevalência de doenças crônicas aumentou de 15,0% a 22,5%. A proporção de busca de atendimento cresceu de 15,3 a 18,6%, e de uso de médico, de 71,2% a 76,2%, com amplitudes de variação de 61,4-75,8% e 68,0-80,6% entre as regiões Norte e Sudeste. Para atendimento por problema de saúde, não houve associação significativa com rendimento per capita, após o controle das demais covariáveis. Conclui-se que apesar da expansão da cobertura de utilização de serviços de saúde, as persistentes desigualdades regionais indicam necessidades de saúde não atendidas entre os residentes das regiões menos desenvolvidas. Modelos de atenção focados na prevenção e promoção da saúde são necessários.


Assuntos
Acessibilidade aos Serviços de Saúde , Serviços de Saúde , Brasil/epidemiologia , Necessidades e Demandas de Serviços de Saúde , Humanos , Renda , Fatores Socioeconômicos
17.
Cien Saude Colet ; 26(suppl 1): 2529-2541, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34133632

RESUMO

This paper aimed to describe health insurance coverage in Brazil. Data from the 2013 and 2019 editions of the National Health Survey (PNS) were analyzed. The medical or dental health insurance coverage was analyzed according to demographic and socioeconomic characteristics, work status, urban/rural area, and Federation Unit. Coverage of medical or dental health insurance was 27.9% (95% CI: 27.1-28.8) for 2013 and 28.5% (95% CI: 27.8-29.2) for 2019. The results show coverage is still concentrated in large urban centers, in the Southeast and South, among those with better socioeconomic status and some formal employment. In 2019, only 30.7% of formal workers reported the monthly payment is made directly to the providers, while 72.7% of informal workers reported this information. About 92% of medical health insurance covers hospitalization, and almost 20% of women with health insurance are not covered for labor. Only 11.7% of women aged between 15 and 44 are covered for childbirth by health insurance. The results show the health insurance coverage is still quite unequal, reinforcing the Unified Health System (SUS) importance for the Brazilian population.


Este artigo objetivou descrever a cobertura de plano de saúde no Brasil. Foram analisados dados das edições de 2013 e 2019 da Pesquisa Nacional de Saúde. A cobertura de plano de saúde médico ou odontológico foi analisada segundo características sociodemográficas, econômicas, de trabalho, situação censitária e Unidade da Federação. A cobertura de plano de saúde médico ou odontológico foi 27,9% (IC95%: 27,1-28,8) para 2013 e 28,5% (IC95%: 27,8-29,2) para 2019. Os resultados mostram que a cobertura continua concentrada nos grandes centros urbanos, nas regiões Sudeste e Sul, entre aqueles com melhor nível socioeconômico e aqueles que possuem algum vínculo de trabalho formal. Em 2019, dentre os trabalhadores formalizados, somente 30,7% relatou que o pagamento da mensalidade é feito diretamente a operadora, sendo 72,7% dentre os trabalhadores informais. Cerca de 92% dos planos de saúde médico cobrem internação e dentre as mulheres com plano de saúde, quase 20% delas não possuem cobertura para o parto. Apenas 11,7% das mulheres com idade entre 15 e 44 anos possuem cobertura para o parto através do plano de saúde. Os resultados mostram que a cobertura por plano de saúde mantém-se bastante desigual, reforçando a importância do Sistema Único de Saúde para a população brasileira.


Assuntos
Seguro Saúde , População Rural , Adolescente , Adulto , Brasil , Feminino , Inquéritos Epidemiológicos , Humanos , Cobertura do Seguro , Fatores Socioeconômicos , Adulto Jovem
18.
Epidemiol Serv Saude ; 30(1): e2020294, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33605396

RESUMO

OBJETIVO: To analyze the temporal trend of overweight and obesity prevalence rates among adults in the Brazilian state capitals and Federal District between 2006 and 2019. METHODS: This was a time series study using data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey, 2006-2019 (n=730,309). Prevalence of overweight and obesity for each of the years was analyzed, according to combined sex, age, and schooling. Temporal variation trend was analyzed using Prais-Winsten regression. RESULTS: Variations in overweight prevalence were observed, mainly among males 18-24 years old with up to 8 years of schooling (3.17%/year) and among women between 18-24 years old with more than 12 or more years of schooling (6.81% /year). Variations in obesity prevalence were found mainly among women 18-24 years old with more than 12 years of schooling (10.79%/year). CONCLUSION: There was an increase in overweight and obesity in most of the socio-demographic strata studied, especially among more educated young people.


Assuntos
Obesidade , Sobrepeso , Adolescente , Adulto , Brasil/epidemiologia , Escolaridade , Feminino , Humanos , Masculino , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Prevalência , Adulto Jovem
19.
Epidemiol Serv Saude ; 29(5): e2020315, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33027428

RESUMO

This article presents the history and construction of the National Health Survey (PNS) 2019, a household survey conducted in partnership with the Brazilian Institute of Geography and Statistics. The objective of PNS 2019 was to provide the country with information on the health determinants, conditionants and needs of the Brazilian population. The expected sample was 108,525 households, considering a 20% non-response rate. The questionnaire had three parts, covering: (i) the household; (ii) all residents of the household, focusing on collection of socioeconomic and health information; and (iii) the selected resident (15 years old or more) for whom lifestyles, chronic diseases, violence, among other topics were investigated, as well as their anthropometric measurements (subsample). The information provided by PNS 2019 will serve as a basis for the (re)formulation of health policies, as well as support for existing actions and programs of the Brazilian National Health System.


Este artigo apresenta o histórico e a construção da Pesquisa Nacional de Saúde (PNS) 2019, inquérito de base domiciliar realizado em parceria com o Instituto Brasileiro de Geografia e Estatística. O objetivo da PNS 2019 foi dotar o país de informações sobre os determinantes, condicionantes e necessidades de saúde da população brasileira. A amostra prevista foi de 108.525 domicílios particulares, considerando-se uma taxa de não resposta de 20%. Seu questionário continha três partes, orientadas para (i) o domicílio, (ii) todos os moradores do domicílio, com enfoque na coleta de informações socioeconômicas e de saúde, e (iii) o morador selecionado (idade ≥15 anos), sendo investigados estilos de vida, doenças crônicas, violências, entre outros temas, e aferidas medidas antropométricas (subamostra). As informações da PNS 2019 servirão de base para a (re)formulação de políticas de saúde e subsídio a ações e programas existentes do Sistema Único de Saúde.


Este artículo presenta la historia y la construcción de la Encuesta Nacional de Salud (PNS) 2019, una encuesta domiciliaria realizada en colaboración con el Instituto Brasileño de Geografía y Estadística. El objetivo de la PNS fue proporcionar al país información sobre los determinantes, las condiciones y las necesidades de salud de la población brasileña. La muestra esperada fue de 108.525 hogares particulares, considerando una tasa de no respuesta del 20%. Su cuestionario contenía tres partes: (i) con respecto al hogar; (ii) dirigido a todos los residentes, centrándose en la recopilación de información socioeconómica y de salud; y (iii) al residente seleccionado (15 años o más) de quien se investigó estilos de vida, enfermedades crónicas, violencia, entre otros temas y se compararon las medidas antropométricas (submuestra). La información de la PNS 2019 servirá como base para la (re)formulación de políticas de salud y para apoyar acciones y programas existentes en el Sistema Único de Salud.


Assuntos
Inquéritos Epidemiológicos , Brasil , Inquéritos Epidemiológicos/história , Inquéritos Epidemiológicos/métodos , História do Século XXI , Humanos
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