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BACKGROUND: To guarantee prevention and adequate treatment, as required for the population to have access to health services and technologies, including medicines. The purpose of this study is to analyse the economic and regional inequalities in access to medicines for diabetes and hypertension among the adult population in Brazil. METHODS: This was a cross-sectional study with adults aged 18 and over from the VIGITEL study conducted in 2019 in all Brazilian regions. Non-access to antidiabetic and antihypertensive drugs was assessed according to formal education and housing macro-region. The slope index of inequality (SII) was used to analyse absolute inequalities. RESULTS: The total number of individuals interviewed was 52,443. Approximately 10.0% of the people with diabetes and/or hypertension reported not having access to drug treatment. The major means for having access to antihypertensive drugs, in all regions, was private pharmacies; for antidiabetics, in the North region, people had greater access through private pharmacies, while in the Northeast, Southeast and South, they had greater access through the public sector. Inequalities were found in the lack of access to medicines according to the region of residence, especially in the North region. CONCLUSION: The lack of access to medicines showed regional disparities, particularly in the most economically vulnerable regions.

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BACKGROUND: Despite available information on trends in behavioral factors for Brazil and Argentina, little is known about the association of these trends with mortality. Understanding this association is important to avoid early deaths. Therefore, we aimed to evaluate temporal trends in behavioral risk and protective factors in Brazil and Argentina, and to assess their association with overall and cause-specific mortality rates. METHODS: Ecological study with data from two population surveys from Brazil and Argentina. Weighted prevalence of tobacco smoking, excessive alcohol consumption, fruit and vegetable consumption and physical activity for the 27 Brazilian state capitals and for the 23 Argentinean provinces were used as behavioral factors. Information on overall mortality as well as cardiovascular diseases and cancer mortality for the year 2015 was collected from national mortality banks of both countries. Estimated prevalence rates were used to describe trends in behavioral factors from 2006 to 2014 in Brazil, and from 2005 to 2013 in Argentina, while Pearson's correlation and linear regression models were used to assess their association with overall and cause-specific mortality rates. RESULTS: Brazil presented improvements in behavioral risk and protective factors: sharp decrease in tobacco smoking prevalence (from 15 to 9%), increase in regular fruit and vegetable consumption (from 28 to 36%), and increase in physical activity (45 to 51%). In Argentina, results were more disappointing: small reduction in tobacco smoking (from 55 to 50%) and decrease in physical activity (from 55 to 45%). In both countries, excessive alcohol consumption remained stable, with increase only among women. The association between behavioral factors and mortality showed that in those Brazilian capitals with higher prevalence of regular consumption of fruits and vegetables, there were lower overall mortality rates. Stratification by gender revealed that significant results were only found among women. CONCLUSION: Prevalence of regular consumption of fruits and vegetables increased in Brazilian capitals and was associated with lower overall mortality rate, suggesting a positive impact of Brazilian policies to improve dietary intake patterns on its population's mortality. Approaches focusing on behavioral factors are especially needed in Argentina to reach similar results of those seen in Brazil.

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Resumo Introdução A qualidade de vida de trabalhadores interfere no desenvolvimento e na produtividade do trabalho e pode ser influenciada por diversos fatores sociodemográficos e laborais. Objetivo Avaliar os fatores associados à qualidade de vida de funcionários de uma Universidade. Método Estudo transversal realizado com 214 trabalhadores de ambos os sexos pertencentes aos dezenove setores da Universidade. Para avaliar a qualidade de vida, utilizou-se o WHOQOL-Bref. A associação de cada domínio da qualidade de vida com as variáveis de exposição foi avaliada através do teste t para amostras independentes ou análise de variância, seguida do teste de Bonferroni. Resultados As médias dos domínios de qualidade de vida foram: 74,64 (±13,52) para o físico, 71,12 (±12,85) para o psicológico, 76,94 (±13,98) para o de relações sociais e 61,94 (±16,30) para o ambiente. Os homens apresentaram maiores médias para os domínios físico, psicológico e de relações sociais. Trabalhadores com idade maior do que 38 anos apresentaram maiores médias no domínio psicológico. Já no domínio relações sociais, as maiores médias foram observadas entre os indivíduos de 18 a 27 anos. Naqueles indivíduos que dormiam menos de 8 horas por dia, as médias do domínio físico foram menores. Conclusão Fazem-se necessárias ações de prevenção e promoção da qualidade de vida no trabalho, especialmente direcionadas aos funcionários que apresentaram as menores médias nos domínios de qualidade de vida.

Abstract Background Life quality of workers influences on development and productivity of work and it can be influenced by several sociodemographic and labor factors. Objective To evaluate the associated factors with quality of life of University workers from southern Santa Catarina State. Method A cross-sectional study with 214 workers was carried out. WHOQOL-Bref was used to evaluate the quality of life. The quality of life domains were associated to exposure variables. The statistical analysis T-test for independent samples and analysis of variance, followed by the Bonferroni test were used. Results The mean of quality of life domains were: 74.64 (±13.52) for the physical domain, 71.12 (±12.85) for the psychological, 76.94 (±13.98) for social relations domain and 61.94 (±16.30) for the environment domain. Males presented higher mean for the physical, psychological and social relations domains. Workers older than 38 years of age presented higher means in the psychological domain. In the social relations domain, the highest mean was observed among individuals aged 18 to 27 years. In those individuals who slept less than 8 hours a day, the mean of the physical domain were smaller. Conclusion It is necessary the development of actions to prevent and promote life quality at work focusing on employees who had the lowest averages of the domains of that.

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The aim of this study was to estimate the association between birth order and number of siblings with body composition in adolescents. Data are from a birth cohort study conducted in Pelotas, Brazil. At the age of 18 years, 4563 adolescents were located, of whom 4106 were interviewed (follow-up rate 81.3 %). Of these, 3974 had complete data and were thus included in our analysis. The variables used in the analysis were measured during the perinatal period, or at 11, 15 and/or 18 years of age. Body composition at 18 years was collected by air displacement plethysmography (BOD POD®). Crude and adjusted analyses of the association between birth order and number of siblings with body composition were performed using linear regression. All analyses were stratified by the adolescent sex. The means of BMI, fat mass index and fat-free mass index among adolescents were 23.4 (sd 4.5) kg/m², 6.1 (sd 3.9) kg/m² and 17.3 (sd 2.5) kg/m², respectively. In adjusted models, the total siblings remained inversely associated with fat mass index (ß = - 0.37 z-scores, 95 % CI - 0.52, - 0.23) and BMI in boys (ß = - 0.39 z-scores, 95 % CI - 0.55, - 0.22). Fat-free mass index was related to the total siblings in girls (ß = 0.06 z-scores, 95 % CI - 0.04, 0.17). This research has found that number of total siblings, and not birth order, is related to the fat mass index, fat-free mass index and BMI in adolescents. It suggests the need for early prevention of obesity or fat mass accumulation in only children.

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