Chan Jasper J L, Tran-Nhu Linh, Pitcairn Charlie F M, Laverty Anthony A, Mrejen Matías, Pescarini Julia M, Hone Thomas V
Imperial College School of Public Health, Imperial College London, London, United Kingdom.
Division of Biosciences, University College London, London, United Kingdom.
PLOS Glob Public Health. 2022 Sep 8;2(9):e0000990. doi: 10.1371/journal.pgph.0000990. eCollection 2022.
Social and environmental risk factors in informal settlements and slums may contribute to increased risk of cardiovascular disease (CVD). This study assesses the socioeconomic inequalities in CVD risk factors in Brazil comparing slum and non-slum populations.
Responses from 94,114 individuals from the 2019 Brazilian National Health Survey were analysed. The United Nations Human Settlements Programme definition of a slum was used to identify slum inhabitants. Six behavioural risk factors, four metabolic risk factors and doctor-diagnosed CVD were analysed using Poisson regression models adjusting for socioeconomic characteristics.
Compared to urban non-slum inhabitants, slum inhabitants were more likely to: have low (less than five days per week) consumption of fruits (APR: 1.04, 95%CI 1.01-1.07) or vegetables (APR: 1.08, 95%CI 1.05-1.12); drink four or more alcoholic drinks per day (APR: 1.05, 95%CI 1.03-1.06); and be physically active less than 150 minutes per week (APR: 1.03, 95%CI 1.01-1.04). There were no differences in the likelihoods of doctor-diagnosed metabolic risk factors or CVD between the two groups in adjusted models. There was a higher likelihood of behavioural and metabolic risk factors among those with lower education, with lower incomes, and the non-White population.
Brazilians living in slums are at higher risk of behavioural risk factors for CVD, suggesting local environments might impact access to and uptake of healthy behaviours.
非正式定居点和贫民窟中的社会及环境风险因素可能会增加心血管疾病（CVD）的风险。本研究比较了巴西贫民窟和非贫民窟人群心血管疾病风险因素方面的社会经济不平等情况。
对来自2019年巴西全国健康调查的94114人的回复进行了分析。采用联合国人类住区规划署对贫民窟的定义来确定贫民窟居民。使用泊松回归模型对社会经济特征进行调整，分析了六种行为风险因素、四种代谢风险因素以及医生诊断的心血管疾病。
与城市非贫民窟居民相比，贫民窟居民更有可能：水果（调整后风险比：1.04，95%置信区间1.01 - 1.07）或蔬菜（调整后风险比：1.08，95%置信区间1.05 - 1.12）的摄入量低（每周少于五天）；每天饮用四杯或更多酒精饮料（调整后风险比：1.05，95%置信区间1.03 - 1.06）；每周进行体育活动少于150分钟（调整后风险比：1.03，95%置信区间1.01 - 1.04）。在调整后的模型中，两组之间医生诊断的代谢风险因素或心血管疾病的可能性没有差异。在受教育程度较低、收入较低的人群以及非白人人群中，行为和代谢风险因素的可能性更高。
生活在贫民窟的巴西人患心血管疾病行为风险因素的风险更高，这表明当地环境可能会影响健康行为的获取和采用。
