de Azevedo Barros Marilisa Berti, Lima Margareth Guimarães, Medina Lhais de Paula Barbosa, Szwarcwald Celia Landman, Malta Deborah Carvalho
State University of Campinas - UNICAMP, Campinas, Brazil.
Department of Public Health - UNICAMP - Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz, 13083-887, Campinas, SP, Brazil.
Int J Equity Health. 2016 Nov 17;15(1):148. doi: 10.1186/s12939-016-0439-0.
Considering the high socioeconomic inequalities prevailing in Brazil and lifestyle as a strong determinant of morbidity and premature mortality, our purpose was to evaluate the degree of socioeconomic disparities in the prevalence of health behaviors among Brazilian adult population using data from the 2013 Brazilian National Health Survey.
Based on a sample of 49,025 individuals aged 20 to 59 years, we estimated the prevalence of several health behaviors and a score of unhealthy behaviors according to gender, education, race/color and possession of private health insurance. The prevalence ratios adjusted by age and gender were estimated by means of multiple Poisson regression and the analyses took into account the sampling design.
Significant social inequalities were identified in the Brazilian adults. Higher prevalence of current smoking, leisure-time physical inactivity, sedentary lifestyle, whole milk consumption and low ingestion of greens, vegetables, and fruits were observed among the less educated, in the non-white population, and among those without private health insurance. Higher prevalence of heavy episodic drinking was found in the non-white population, but no difference in the consumption of fatty meat was found according to skin color. Score of unhealthy behavior higher than 6 was more frequent in lower educational strata (PR = 3.74) in the non-white population (PR = 1.39) and among those without private health insurance (PR = 1.78). Compared to women, men had higher prevalence rates of smoking, hazardous alcohol consumption, and fatty meat consumption and lower consumption of greens, vegetables and fruits.
The results of the study emphasize the importance of monitoring social inequalities in health as part of national health policies and the urgent need to prioritize actions to promote healthy behaviors, especially among the most socially vulnerable segments of society.
鉴于巴西存在高度的社会经济不平等现象，且生活方式是发病率和过早死亡率的重要决定因素，我们的目的是利用2013年巴西全国健康调查的数据，评估巴西成年人口健康行为流行率中的社会经济差异程度。
基于49025名年龄在20至59岁之间的个体样本，我们根据性别、教育程度、种族/肤色和是否拥有私人健康保险，估计了几种健康行为的流行率以及不健康行为得分。通过多重泊松回归估计经年龄和性别调整的流行率比，分析考虑了抽样设计。
在巴西成年人中发现了显著的社会不平等现象。在受教育程度较低者、非白人人群以及没有私人健康保险的人群中，当前吸烟、休闲时间缺乏身体活动、久坐不动的生活方式、全脂牛奶消费以及绿色蔬菜、蔬菜和水果摄入量低的流行率较高。在非白人人群中发现重度暴饮的流行率较高，但根据肤色，在食用肥肉方面未发现差异。不健康行为得分高于6在低教育阶层（PR = 3.74）、非白人人群（PR = 1.39）以及没有私人健康保险的人群（PR = 1.78）中更为常见。与女性相比，男性吸烟、有害饮酒和食用肥肉的流行率较高，而绿色蔬菜、蔬菜和水果的消费量较低。
该研究结果强调了监测健康方面的社会不平等作为国家卫生政策一部分的重要性，以及迫切需要优先采取行动促进健康行为，特别是在社会最弱势群体中。
