RESUMEN
BACKGROUND: Information on socioeconomic inequalities in physical activity over time is sparse in low- to middle-income countries. In this study, we examined trends in physical activity educational inequalities in adults from Brazil between 2013 and 2019. METHODS: We analyzed data from seven cross-sectional studies including 359,038 adults (≥ 18 years) from the VIGITEL study conducted annually from 2013 to 2019. Participants responded to a questionnaire about physical activity (total, leisure, and commuting). Educational inequalities by sex and skin color were assessed through absolute (slope index of inequality - SII) and relative measures of inequality (concentration index - CIX). RESULTS: We found large absolute and relative inequalities for leisure-time physical activity, favoring those with higher educational attainment (SII2019 = 35.4; CIX2019 = 11.82). Active commuting was more prevalent in intermediate education groups, with a slight inequality toward the less educated group (SII2019 = -2.8; CIX2019 = -0.4). From 2013 to 2019, the absolute educational inequality in physical activity (total, leisure, and commuting) remained unchanged; however, the relative inequality gap narrowed for total physical activity (CIX: 8.4 in 2013 to 5.5 in 2019) and leisure-time physical activity (CIX: 18.3 in 2013 to 11.8 in 2019). Educational inequality increased in leisure-time physical activity among women and non-white individuals, while it reduced among men and white individuals; for active commuting, inequality decreased among women, and increased among men and white individuals. CONCLUSIONS: Inequality in total physical activity and leisure-time physical activity favors the most educated groups in Brazil. Over time, relative educational inequality decreased for total and leisure-time physical activity, while no progress was found for absolute inequality.
Asunto(s)
Ejercicio Físico , Actividades Recreativas , Factores Socioeconómicos , Adulto , Brasil , Estudios Transversales , Escolaridad , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVES: Our study aimed to assess social inequality trends for hypertension, diabetes mellitus, smoking and obesity from 2007 to 2018 in adults from Brazilian capitals. SETTING: Data from the Surveillance of Risk and Protection Factors for Chronic Diseases by Telephone Survey study, a cross-sectional telephone survey, conducted annually from 2007 to 2018. PARTICIPANTS: We used data from 578 977 Brazilian adults (≥18 years). DESIGN: Cross-sectional surveys conducted annually from 2007 to 2018. PRIMARY OUTCOME MEASURES: Participants responded to a questionnaire about medical diagnosis of hypertension and diabetes, smoking status, weight and height. Educational inequalities (0-3, 4-8, 9-11 and 12 or more years of study) by sex and skin colour were assessed trough absolute, Slope Index of Inequality (SII) and relative measures of inequality, Concentration Index and trends were tested by Prais-Winsten. RESULTS: All outcomes were more prevalent in the least educated. The largest absolute educational inequality was observed for hypertension (SIItotal=-37.8 in 2018). During 2007-2018, the total educational disparity remained constant for hypertension, increased for diabetes and smoking, and decreased for obesity. Overall, inequality was higher among women and non-whites, compared with men and whites. We found a reduction in absolute inequality for hypertension among non-whites, an increase for diabetes in all strata, and an increase for smoking in women and non-whites. The relative inequality decreased in women and whites and increased for smoking in all strata, except among men. CONCLUSION: The educational inequality reduced for obesity, remained constant for hypertension and increased for diabetes and smoking from 2007 to 2018 in Brazilian adults.