RESUMO

Resumo A realização do Censo Demográfico 2022 trouxe à tona o debate acerca da inclusão de variáveis que permitissem alcançar minorias sexuais com baixa ou nenhuma cobertura em inquéritos populacionais oficiais no Brasil. A pauta se justifica tendo em vista que a população LGBTI+ reivindica visibilidade estatística e demanda políticas públicas para a garantia de seus direitos. O presente artigo analisa o processo de elaboração e inclusão das variáveis orientação sexual e identidade de gênero nas pesquisas domiciliares oficiais de âmbito nacional do IBGE. Para tal, foi realizado um mapeamento das experiências internacionais, que mostrou essa investigação sendo inicialmente aplicada sobretudo em inquéritos de saúde, por meio de autodeclaração e uso do método "2-step" para identificação da população trans. Além disso, sob a luz da bibliografia existente, são apresentadas as etapas de planejamento, os desafios e as perspectivas futuras de investigação do tema. Com isso, espera-se contribuir para um debate informado, tendo em vista a atual invisibilidade da população LGBTI+ nas bases de dados populacionais oficiais.

Abstract The 2022 Demographic Census shed light on the debate concerning the inclusion of variables that would allow one to reach sexual minorities with low or no coverage in official population surveys in Brazil. The agenda is justified, considering that the LGBTI+ population demands statistical visibility and calls for public policies to guarantee their rights. This article analyzes the process of the formulation and inclusion of the sexual orientation and gender identity variables in the IBGE's official national household surveys. To this end, a mapping of international experiences was carried out, which showed that this investigation was initially applied in health surveys through self-reports and the use of the "2-step" method to identify the trans population. Furthermore, in the light of the existing bibliography, the planning stages, challenges, and future perspectives for investigating the topic are presented. With this, we hope to contribute to an informed debate, given the current invisibility of the LGBTI+ population in official population databases.

Resumen El Censo Demográfico de 2022 ha despertado el debate sobre la inclusión de variables que permitan alcanzar a las minorías sexuales con baja o nula cobertura en las encuestas oficiales de población en Brasil. El tema se justifica dado que la población LGBTI+ reclama visibilidad estadística y exige políticas públicas que garanticen sus derechos. Este artículo analiza el proceso de elaboración e inclusión de las variables orientación sexual e identidad de género en las encuestas de hogares oficiales de IBGE en ámbito nacional. Para ello, se realizó un mapeo de las experiencias internacionales, mostrando que esta investigación se aplicó inicialmente sobre todo en las encuestas de salud, a través de la autodeclaración y el uso del método de los "2-step" para identificar a la población trans. Además, a la luz de la bibliografía existente, se presentan las etapas de planificación, los desafíos y las perspectivas futuras de la investigación sobre el tema. Se espera, por tanto, contribuir a un debate informado, dada la actual invisibilidad de la población LGBTI+ en las bases de datos poblacionales oficiales.

RESUMO

High-quality health systems must provide accessible, people-centred care to both improve health and maintain population trust in health services. Furthermore, accurate measurement of population perspectives is vital to hold health systems accountable and to inform improvement efforts. To describe the current state of such measures in Latin America and the Caribbean (LAC), we conducted a systematic review of facility and population-based assessments that included patient-reported experience and satisfaction measures. Five databases were searched for publications on quantitative surveys assessing healthcare quality in Spanish- or Portuguese-speaking LAC countries, focusing on the domains of processes of care and quality impacts. We included articles published since 2011 with a national sampling frame or inclusion of multiple subnational regions. We tabulated and described these articles, identifying, classifying and summarizing the items used to assess healthcare quality into the domains mentioned earlier. Of the 5584 publications reviewed, 58 articles met our inclusion criteria. Most studies were cross-sectional (95%), assessed all levels of healthcare (57%) and were secondary analyses of existing surveys (86%). The articles yielded 33 unique surveys spanning 12 LAC countries; only eight of them are regularly administered surveys. The most common quality domains assessed were satisfaction (in 33 out of 58 articles, 57%), evidence-based/effective care (34%), waiting times (33%), clear communication (33%) and ease of use (31%). Items and reported ratings varied widely among instruments used, time points and geographical settings. Assessment of patient-reported quality measures through population- and facility-based surveys is present but heterogeneous in LAC countries. Satisfaction was measured frequently, although its use in accountability or informing quality improvement is limited. Measurement of healthcare quality in LAC needs to be more systematic, regular, comprehensive and to be led collaboratively by researchers, governments and policymakers to enable comparison of results across countries and to effectively inform policy implementation.

Assuntos

RESUMO

ABSTRACT Objective: The national vaccination coverage survey on full vaccination at 12 and 24 months of age was carried out to investigate drops in coverage as of 2016. Methods: A sample of 37,836 live births from the 2017 or 2018 cohorts living in capital cities, the Federal District, and 12 inner cities with 100 thousand inhabitants were followed for the first 24 months through vaccine record cards. Census tracts stratified according to socioeconomic levels had the same number of children included in each stratum. Coverage for each vaccine, full vaccination at 12 and 24 months and number of doses administered, valid and timely, were calculated. Family, maternal and child factors associated with coverage were surveyed. The reasons for not vaccinating analyzed were: medical contraindications, access difficulties, problems with the program, and vaccine hesitancy. Results: Preliminary results showed that less than 1% of children were not vaccinated, full coverage was less than 75% at all capitals and the Federal District, vaccines requiring more than one dose progressively lost coverage, and there were inequalities among socioeconomic strata, favorable to the highest level in some cities and to the lowest in others. Conclusion: There was an actual reduction in full vaccination in all capitals and the Federal District for children born in 2017 and 2018, showing a deteriorating implementation of the National Immunization Program from 2017 to 2019. The survey did not measure the impacts of the COVID-19 pandemic, which may have further reduced vaccination coverage.

RESUMO Objetivo: Inquérito nacional de cobertura vacinal aos 12 e 24 meses de idade foi realizado para investigar as quedas nas coberturas a partir de 2016. Métodos: Amostra de 37.836 nascidos vivos das coortes de 2017 e 2018 residentes nas capitais, Distrito Federal (DF) e 12 cidades com mais de 100 mil habitantes, acompanhados nos primeiros 24 meses por registros nas cadernetas de vacinação. Setores censitários foram estratificados segundo condições socioeconômicas, e o mesmo número de crianças foi incluído para cada estrato. Calcularem-se coberturas vacinais de cada vacina e coberturas completas aos 12 e 24 meses, doses aplicadas, válidas e oportunas. Fatores familiares, maternos e da criança associados à cobertura foram pesquisados. Os motivos para não vacinar analisados foram: contraindicações médicas, dificuldades de acesso, problemas no funcionamento do programa e hesitação vacinal. Resultados: Os resultados preliminares mostram que menos de 1% das crianças não foram vacinadas, as coberturas pelo esquema completo são menores que 75% em todas as capitais e no DF, as vacinas com mais de uma dose perdem cobertura progressivamente, há diferenças entre os estratos socioeconômicos, favoráveis aos estratos mais altos em algumas cidades e aos estratos mais baixos em outras. Conclusão: Houve realmente redução da cobertura vacinal em todas as capitais e no DF para as crianças nascidas em 2017 e 2018, denotando piora na execução do Programa Nacional de Imunizações durante os anos de 2017 a 2019. O inquérito realizado não mensurou os impactos da pandemia de COVID-19 que podem ter reduzido ainda mais as coberturas vacinais.

RESUMO

Abstract Brazil is characterized by strong social inequalities and differences in access to quality food and sufficient quantities of it, which represent a violation of the human right to adequate food. The aim was to assess food expenditures according to the social profiles of the head of the households. Data from the cross-sectional Brazilian Household Budget Survey (2017/2018) were used with a nationally representative sample of household survey participants (n=52,917). Poisson regression was used to estimate prevalence ratios (PR) to assess the association of different social profiles with the acquisition of food. The profile characterized by woman self-classified as white, with a higher education, which characteristics were positively and significantly associated with more acquisition of fruits (PR=1.22; CI95% 1.09-1.36) and vegetables and greens (PR=1.24; CI95% 1.09-1.41). Black women with low education levels showed a negative association with the consumption of soda (PR=0.53; CI95% 0.45-0.62), and prepared food (PR=0.52; CI95% 0.37-0.74). The results reveal great inequalities in the purchase of food between the social profiles of the heads of the family.

Resumo O Brasil é caracterizado por fortes desigualdades sociais e diferenças no acesso a alimentos de qualidade e em quantidade suficiente, o que representa uma violação do direito humano à alimentação adequada. O objetivo foi avaliar os gastos com alimentação de acordo com o perfil social do responsável pelo domicílio. Dados da Pesquisa de Orçamentos Familiares Brasileiros de corte transversal (2017/2018) foram usados com uma amostra nacionalmente representativa de participantes da pesquisa domiciliar (n=52.917). A regressão de Poisson foi utilizada para estimar razões de prevalência (RP) para avaliar a associação de diferentes perfis sociais com a aquisição de alimentos. O perfil caracterizado pela mulher auto classificada como branca, com maior escolaridade, cujas características estiveram positiva e significativamente associadas a maior aquisição de frutas (RP=1,22; IC95% 1,09-1,36), verduras e legumes (PR=1,24; IC95% 1,09-1,41) e queijo (RP=1,32; IC95% 1,09-1,59). Mulheres negras com baixa escolaridade apresentaram associação negativa com o consumo de refrigerantes (RP=0,53; IC95% 0,45-0,62) e alimentos preparados (RP=0,52; IC95% 0,37-0,74). Os resultados revelam grandes desigualdades na aquisição de alimentos entre os perfis sociais dos chefes de família.

RESUMO

Resumo Objetivo Verificar a relação entre a autopercepção de saúde positiva (AS positiva) em idosos de baixa escolaridade com variáveis demográficas, de participação social e comportamentais. Método Tratou-se de um estudo transversal (n=12.367), com idosos de mais de 60 anos de ambos os sexos, com até quatro anos de estudo de diversas cidades do Brasil entrevistados pela Pesquisa Nacional de Saúde do ano de 2019. Para a análise de dados, inicialmente, realizou-se a descrição das prevalências e, posteriormente, construíram-se três modelos de regressão de Poisson com ajuste robusto para variância, sendo as análises estratificadas por sexo. Resultados A prevalência de AS positiva foi de 38,8% nos homens e 34,8% nas mulheres. No último modelo de regressão construído foram encontradas associações com menores prevalências de AS positiva nas mulheres pretas ou pardas, enquanto maiores prevalências foram encontradas nas solteiras, com renda mais elevada, que participam de alguma associação, de atividades religiosas, iam ao médico com mais frequência, eram fisicamente ativas e consumiam regularmente frutas e hortaliças. Nos homens, foram encontradas menores prevalências nos pretos ou pardos e nos viúvos, já maiores prevalências foram encontradas naqueles que participavam de atividades religiosas e iam ao médico mais frequentemente. Conclusões O estudo reforça a importância de políticas para a melhoria de renda, bem como para promoção de comportamentos saudáveis e estímulo a participação social.

Abstract Objective To verify the relationship between positive self-perception of health (positive SPH) in less-educated older adults and demographic, social participation, and behavioral variables. Methods This was a cross-sectional study (n=12,367), with elderly people over 60 years old of both sexes, with up to four years of study from several cities in Brazil, interviewed by the National Health Survey of the year 2019. For the analysis of data, the prevalence was initially described, and later, three Poisson regression models with robust adjustment for variance were constructed, with the analyzes being stratified by sex Results The prevalence of positive SPH was 38.8% in men and 34.8% in women. The last regression model built revealed associations with a lower positive SPH prevalence in black or brown women. In contrast, higher prevalence levels were found in single women, with higher income, participating in some associations, engaged in religious activities, visiting the doctor more often, physically active, and regularly consuming fruits and vegetables. In men, relationships with lower prevalence were found in blacks or browns and widowers, and higher prevalence levels were found in those engaging in religious activities and visiting the doctor more often. Conclusions The study reinforces the importance of policies aimed at improving income, promoting healthy behaviors and encouraging social participation.

RESUMO

Objetivo: Descrever, comparativamente, as prevalências de doenças crônicas não transmissíveis, consumo de alimentos ultraprocessados, álcool e tabaco, estimadas pelo Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel) e pela Pesquisa Nacional de Saúde (PNS), em Rio Branco, Acre, Brasil. Métodos: Estudo transversal, sobre dados sociodemográficos, de saúde e estilo de vida de inquéritos realizados em 2019. Foram descritas as prevalências e intervalos de confiança de 95% (IC95%), e calculadas as diferenças percentuais. Resultados: Dos 3.037 indivíduos avaliados, observaram-se prevalências similares com diferença para pessoas de raça/cor da pele parda, entre Vigitel (60,3%; IC95% 56,2;64,3) e PNS (70,8%; IC95% 67,4;73,9). Na estratificação por sexo, diferenças percentuais entre os inquéritos foram observadas para obesidade (masculino= 6,5%; feminino= 0,4%), tabagismo (masculino= 4,0%; feminino= -1,5%) e consumo abusivo de álcool (masculino= 6,9%; feminino= -2,5%), embora com IC95% sobrepostos. Conclusão: As estimativas avaliadas em ambos os inquéritos foram similares.

Objetivo: Comparar la prevalencia de enfermedades crónicas no transmisibles, consumo de alimentos ultraprocesados, alcohol y tabaco, según el Sistema de Vigilancia de Factores de Riesgo y Protección de Enfermedades Crónicas por Encuesta Telefónica (Vigitel) y por la Encuesta Nacional de Salud (PNS), en Rio Branco, Acre. Métodos: Estudio transversal, utilizando variables sociodemográficas, salud y estilo de vida de encuestas de 2019. Se describieron prevalencias e intervalos de confianza al 95% (IC95%) y se calcularon diferencias porcentuales. Resultados: En los 3.037 individuos evaluados, hubo similitud en la prevalencia, con diferencia en raza/color de piel parda en Vigitel (60,3%; IC95% 56,2;64.3) y en PNS (70,8%; IC95% 67,4;73,9). En la estratificación por sexo, se observaron diferencias porcentuales entre las encuestas para obesidad (hombres= 6,5%; mujeres= 0,4%), tabaquismo (hombres= 4,0%; mujeres= -1,5%) y abuso de alcohol (hombres= 6,9%; mujeres= -2,5%), pero con IC95% superpuesto. Conclusión: Las encuestas arrojaron estimaciones similares.

Objective: To describe, in a comparative manner, the prevalence of chronic non-communicable diseases and ultra-processed food, alcohol and tobacco consumption, estimated by the Chronic Disease Risk and Protective Factors Surveillance Telephone Survey (Vigitel) and National Health Survey (PNS), in Rio Branco, capital city of the state of Acre, Brazil. Methods: This was a cross-sectional study on sociodemographic, health and lifestyle data from surveys conducted in 2019. Prevalence and 95% confidence intervals (95%CI) were described, and percentage difference was calculated. Results: Of the 3,037 individuals assessed, similar prevalence, with difference between Vigitel (60.3%; 95%CI 56.2;64.3) and PNS (70.8%; 95%CI 67.4;73.9) regarding people of Brown race/skin color was found. In the stratification by sex, it could be seen percentage difference between the surveys, regarding obesity (male= 6.5%; female= 0.4%), smoking (male= 4.0%; female= -1.5%) and alcohol abuse (male= 6.9%; female= -2.5%), although with overlapping 95%CI. Conclusion: The estimates assessed in both surveys were similar.

Assuntos

RESUMO

The Washington Group (WG) tools capture self-reported functional limitations, ranging from 6 domains in the Short Set (SS) to 11 in the Extended Set (ESF). Prevalence estimates can vary considerably on account of differences between modules and the different applications of them. We compare prevalence estimates by WG module, threshold, application and domain to explore these nuances and consider whether alternative combinations of questions may be valuable in reduced sets. We conducted secondary analyses of seven population-based surveys (analyses restricted to adults 18+) in Low- and Middle-Income Countries that used the WG tools. The prevalence estimates using the SS standard threshold (a lot of difficulty or higher in one or more domain) varied between 3.2% (95% Confidence Interval 2.9-3.6) in Vanuatu to 14.1% (12.2-16.2) in Turkey. The prevalence was higher using the ESF than the SS, and much higher (5 to 10-fold) using a wider threshold of "some" or greater difficulty. Two of the SS domains (communication, self-care) identified few additional individuals with functional limitations. An alternative SS replacing these domains with the psychosocial domains of anxiety and depression would identify more participants with functional limitations for the same number of items. The WG tools are valuable for collecting harmonised population data on disability. It is important that the impact on prevalence of use of different modules, thresholds and applications is recognised. An alternative SS may capture a greater proportion of people with functional domains without increasing the number of items.

Assuntos

RESUMO

Resumen Objetivo: Actualizar la prevalencia de desnutrición y sus tendencias en los últimos 30 años e identificar factores asociados con la baja talla en una muestra representativa nacional de niños <5 años en México. Material y métodos: Se estimaron prevalencias de desnutrición en <5 años en 2018-19 y se compararon con prevalencias de los últimos 30 años. Se estudiaron asociaciones de factores geográficos, del hogar, maternos e individuales con baja talla, utilizando regresión logística múltiple. Resultados: El 4.8% de los niños <5 años presentó bajo peso, 14.2% baja talla y 1.4% emaciación. Entre 1988-2012 hubo un descenso en baja talla interrumpido entre 2012-2018. La baja talla se asoció positivamente con residencia rural, región Sur, hogares más pobres, madres indígenas y mayor número de hijos, y negativamente con diversidad dietética. Conclusiones: La desnutrición crónica es un problema persistente asociado con factores de vulnerabilidad social, cuya tendencia descendente de 30 años se interrumpió entre 2012-2018. Es imperativo implementar una estrategia nacional de prevención de baja talla.

Abstract Objective: To update malnutrition prevalence and its trends over the last 30 years and identify factors associated with stunting in a national sample of children <5 y in Mexico. Materials and methods: Malnutrition prevalences in children <5 y in 2018-19 were compared with prevalences from the previous 30 years. Associations of stunting with geographic, household, maternal and individual factors were assessed using multiple logistic regressions. Results: 4.8% of children <5 y were underweight, 14.2% stunted and 1.4% wasted. Between 1988-2012 a decreasing trend in stunting was observed that was interrupted between 2012-2018. Stunting was positively associated with children living in rural localities, the Southern Region, poorer households, with indigenous mothers or whose mothers had a greater number of children. A negative association was found with diet diversity. Conclusions: Stunting is a persistent problem associated with social vulnerability that had been declining in the last 30 years; however its descending trend was inter- rupted between 2012 and 2018. It is imperative to implement a national strategy for the prevention of stunting.

RESUMO

ABSTRACT 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.

RESUMO: Objetivo: Analisar a prática de atividade física no lazer, de 2013 e 2019, na população adulta brasileira e segundo características sociodemográficas. Métodos: Análise da base de dados da Pesquisa Nacional de Saúde, comparando-se o indicador de atividade física no lazer na Pesquisa Nacional de Saúde 2013 e 2019. A prevalência de atividade física no lazer (150+ minutos por semana em atividades físicas) foi calculada de acordo com sexo, idade, escolaridade, raça/cor da pele, unidades federativas e regiões do Brasil em 2013 e 2019. Análises de regressão de Poisson e intervalos de confiança de 95% (IC95%) foram utilizados para comparação da atividade física no lazer de diferentes grupos populacionais em 2013 e 2019. Resultados: A proporção de adultos brasileiros ativos no lazer aumentou de 22,7% (IC95% 22,06-23,34), em 2013, para 30,1% (IC95% 29,44-30,67), em 2019. A prevalência de atividade física no lazer aumentou entre 2013 e 2019 em 23 das 27 unidades federativas do Brasil. Tanto em 2013 quanto em 2019, a proporção de ativos no lazer foi maior em homens, jovens, com alta escolaridade e indivíduos com cor da pele branca. De forma geral, a magnitude da diferença na prática de atividade física entre grupos sociodemográficos observada em 2013 diminuiu ligeiramente em 2019. Conclusões: Apesar do aumento na prevalência de atividade física no lazer em adultos brasileiros nos últimos seis anos, marcadas desigualdades sociodemográficas ainda persistem. O sucesso de futuras políticas públicas de promoção da atividade física no lazer deve ser avaliado sob a óptica dos determinantes sociais de saúde e da redução de desigualdades na prática de atividade física.

Assuntos

RESUMO

OBJECTIVE: We set forth to build a prediction model of individuals who would develop bipolar disorder (BD) using machine learning techniques in a large birth cohort. METHODS: A total of 3748 subjects were studied at birth, 11, 15, 18, and 22 years of age in a community birth cohort. We used the elastic net algorithm with 10-fold cross-validation to predict which individuals would develop BD at endpoint (22 years) at each follow-up visit before diagnosis (from birth up to 18 years). Afterward, we used the best model to calculate the subgroups of subjects at higher and lower risk of developing BD and analyzed the clinical differences among them. RESULTS: A total of 107 (2.8%) individuals within the cohort presented with BD type I, 26 (0.6%) with BD type II, and 87 (2.3%) with BD not otherwise specified. Frequency of female individuals was 58.82% (n = 150) in the BD sample and 53.02% (n = 1868) among the unaffected population. The model with variables assessed at the 18-year follow-up visit achieved the best performance: AUC 0.82 (CI 0.75-0.88), balanced accuracy 0.75, sensitivity 0.72, and specificity 0.77. The most important variables to detect BD at the 18-year follow-up visit were suicide risk, generalized anxiety disorder, parental physical abuse, and financial problems. Additionally, the high-risk subgroup of BD showed a high frequency of drug use and depressive symptoms. CONCLUSIONS: We developed a risk calculator for BD incorporating both demographic and clinical variables from a 22-year birth cohort. Our findings support previous studies in high-risk samples showing the significance of suicide risk and generalized anxiety disorder prior to the onset of BD, and highlight the role of social factors and adverse life events.

Assuntos

RESUMO

BACKGROUND: Against a backdrop of population aging and improving survival rates for chronic noncommunicable diseases (CNCD), researchers are placing growing emphasis on health-related quality of life (HRQoL). The aim of this study was to identify the QoL assessment instruments used in population-based studies with adults conducted around the world. METHODS: A systematic review of original research published in all languages between 2008 and 2018 was conducted. Systematic reviews and meta-analyses were excluded. RESULTS: Sixty-three articles (38.1% conducted in the Americas) fitted the eligibility criteria. Based on the AHRQ checklist for cross-sectional studies and the Newcastle-Ottawa scale for cohort studies, methodological quality was shown to be fair in the majority of studies (55.6%) and good in 44.4%. The country with the highest number of publications was Brazil (20.6%). Twelve types of generic instruments and 11 specific instruments were identified. The generic instrument SF-36 was the most frequently used measure (33.3% of studies). In-home interviewing was exclusively used by 47.6% of the studies, while 39 studies (61.9%) reported the use of self-administered questionnaires. Over two-thirds of the studies (34.9%) used questionnaires to investigate the association between chronic diseases and/or associated factors. CONCLUSIONS: It was concluded that the wide range of instruments and modes of questionnaire administration used by the studies may hinder comparisons between population groups with the same characteristics or needs. There is a lack of research on QoL and the factors affecting productive capacity. Studies of QoL in older persons should focus not only on the effects of disease and treatment, but also on the determinants of active aging and actions designed to promote it. Further research is recommended to determine which QoL instruments are best suited for population-based studies.

Assuntos

RESUMO

Resumo O objetivo deste artigo é analisar a tendência temporal e os fatores associados ao consumo de refrigerante ou suco artificial entre adultos no Brasil. Estudo desenvolvido a partir de dados secundários do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico, realizado com adultos brasileiros entre 2007-2014. Foi verificada a frequência e a intensidade do consumo (quantidade de copos ou latas por semana) de refrigerante ou suco artificial. Dados sociodemográficos e comportamentais foram as variáveis independentes. A tendência temporal do consumo anual foi avaliada por meio de Regressão Linear. Os fatores associados (idade, sexo, região, trabalho, escolaridade, hábito de assistir TV) ao consumo dessas bebidas foram investigados por Regressão de Poisson. Houve redução de 32,7% do consumo de refrigerante ou suco artificial entre 2007 e 2014. Os fatores associados ao maior consumo foram: sexo masculino (p = 0,000); faixa etária de 18-29 anos (p = 0,000); residência nas regiões centro-oeste, sudeste e sul (p = 0,000); menor escolaridade (p = 0,616); estar empregado (p = 0,007) e assistir TV mais de 3 horas por dia (p = 0,000). As análises descrevem uma tendência de queda no consumo de refrigerante ou suco artificial entre os adultos no Brasil de 2007 a 2014.

Abstract The scope of this article is to analyze the time-series trend and factors associated with the consumption of soft drinks or packaged fruit juices among adults in Brazil. It is a study based on secondary data from the System of Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey conducted among Brazilian adults between 2007 and 2014. The consumption frequency and intensity (number of cups or cans per week) of soda or packaged juice was checked. Socio-demographic and behavioral data were the independent variables. The time-series trend of annual consumption was evaluated by means of Linear Regression. The factors (age, sex, region, work, schooling and TV screen time) associated with the consumption of these beverages were investigated by Poisson regression. There was a 32.7% reduction in soft drink or packaged juice consumption between 2007 and 2014. Factors associated with higher consumption were: male sex (p = 0.000); 18-29 year-age-range (p = 0.000); residence in the central-west, southeast and southern regions (p = 0.000); lower schooling (p = 0.616); being employed (p = 0.007) and more than 3 hours of TV screen time per day (p = 0.000). The analyses describe a downward trend in the consumption of soda or packaged fruit juice among adults in Brazil from 2007 to 2014.

Assuntos

RESUMO

OBJECTIVE: To describe the undernutrition prevalence, as well as some sociodemographic characteristics associated to stunting in children under five years old, living on locali- ties with less than 100 000 inhabitants in Mexico in 2012 and 2018. MATERIALS AND METHODS: Low weight, stunting and wasting prevalences were calculated in children under 5y according to WHO Growth Reference. A comparison of stunting by sociodemographic and diet diversity variables is presented. Multi-variated logistic models between chronic malnutrition and sociodemographic variables were calculated. RESULTS: In 2018, 4.4% of the individuals suffered low weight, 14.9% stunting and 1.5 % wasting. Stunting was greater in indigenous households (24.5%), households from the lower socioeconomic-index tertile (17.5%), and households with moderated/severe food insecurity (15.3%). Stunting was positively associated with indigenous condition; on the other hand a highly diverse diet resulted to be a protective factor against it. CONCLUSIONS: A high prevalence of chronical malnutrition was documented associated with high poverty conditions. It is important to enforce strategies aimed to contain it, mainlyin such populations with greater social deprivation.

OBJETIVO: Describir la prevalencia de desnutrición infantil y algunas características sociodemográficas asociadas con la desnutrición crónica en menores de cinco años, de localidades de menos de 100 000 habitantes en 2012 y 2018 en México. MATERIAL Y MÉTODOS: Se calcularon prevalencias de bajo peso, desnutrición crónica y emaciación. Se presenta la comparación de la desnutrición crónica por variables sociodemográficas y de diversidad dietética. Se probaron modelos logísticos multivariados entre desnutrición crónica y variables sociodemográficas. RESULTADOS: En 2018, 4.4% presentó bajo peso, 14.9% desnutrición crónica y 1.5% emaciación. La desnutrición crónica fue mayor en hogares indígenas (24.5%), hogares de mayores carencias socioeconómicas (17.5%) y hogares con inseguridad alimentaria moderada/severa (15.3%). La desnutrición crónica se asoció positivamente con habitar hogar indígena y la alta diversidad dietética resultó factor protector de desnutrición crónica. CONCLUSIONES: Se documenta una alta prevalencia de desnutrición crónica asociada con condiciones de alta marginalidad. Es importante fortalecer estrategias diseñadas para contener la desnutrición, sobre todo en las poblaciones de mayores carencias sociales.

Assuntos

RESUMO

Resumen: Objetivo: Describir la prevalencia de desnutrición infantil y algunas características sociodemográficas asociadas con la desnutrición crónica en menores de cinco años, de localidades de menos de 100 000 habitantes en 2012 y 2018 en México. Material y métodos: Se calcularon prevalencias de bajo peso, desnutrición crónica y emaciación. Se presenta la comparación de la desnutrición crónica por variables sociodemográficas y de diversidad dietética. Se probaron modelos logísticos multivariados entre desnutrición crónica y variables sociodemográficas. Resultados: En 2018, 4.4% presentó bajo peso, 14.9% desnutrición crónica y 1.5% emaciación. La desnutrición crónica fue mayor en hogares indígenas (24.5%), hogares de mayores carencias socioeconómicas (17.5%) y hogares con inseguridad alimentaria moderada/severa (15.3%). La desnutrición crónica se asoció positivamente con habitar hogar indígena y la alta diversidad dietética resultó factor protector de desnutrición crónica. Conclusiones: Se documenta una alta prevalencia de desnutrición crónica asociada con condiciones de alta marginalidad. Es importante fortalecer estrategias diseñadas para contener la desnutrición, sobre todo en las poblaciones de mayores carencias sociales.

Abstract: Objective: To describe the undernutrition prevalence, as well as some sociodemographic characteristics associated to stunting in children under five years old, living on localities with less than 100 000 inhabitants in Mexico in 2012 and 2018. Material and methods: Low weight, stunting and wasting prevalences were calculated in children under 5y according to WHO Growth Reference. A comparison of stunting by sociodemographic and diet diversity variables is presented. Multi-variated logistic models between chronic malnutrition and sociodemographic variables were calculated. Results: In 2018, 4.4% of the individuals suffered low weight, 14.9% stunting and 1.5 % wasting. Stunting was greater in indigenous households (24.5%), households from the lower socioeconomic-index tertile (17.5%), and households with moderated/severe food insecurity (15.3%). Stunting was positively associated with indigenous condition; on the other hand a highly diverse diet resulted to be a protective factor against it. Conclusions: A high prevalence of chronical malnutrition was documented associated with high poverty conditions. It is important to enforce strategies aimed to contain it, mainly in such populations with greater social deprivation.

Assuntos

RESUMO

OBJECTIVE: To describe the methodological design of the National Health and Nutrition Survey in localities with less than 100 000 inhabitants (Ensanut 100k). MATERIALS AND METHODS: The Ensanut 100k is a probabilistic survey that over-represents households with less economic capabilities. This paper describes the scope of the survey, sampling procedures, measurement and inference and logistics organization. RESULTS: 10 461 home interviews and 26 161 individual interviews were obtained. The household response rate was 89 and 92% from individuals. CONCLUSIONS: The probabilistic design of the Ensanut 100k allows to make valid statistical inferences about parameters of interest for public health in localities with less than 100 000 inhabitants, localities where 52% of the population lives according to the 2010 census. The comparability of the results with the Ensanut 2012 faci- litates the assessment of the government's support actions to populations with lower economic capacities in the period 2012-2018.

OBJETIVO: Describir el diseño metodológico de la Encuesta Nacional de Salud y Nutrición en localidades con menos de 100 000 habitantes (Ensanut 100k). MATERIAL Y MÉTODOS: La Ensanut 100k es una encuesta probabilística que sobrerrepresenta a los hogares con menos capacidades económicas. Se describe el alcance de la encuesta, los procedimientos de muestreo, medición e inferencia y la organización logística. RESULTADOS: Se obtuvieron 10 461 entrevistas de hogar y 26 161 de individuos. La tasa de respuesta de hogar fue 89% y de individuos 92. CONCLUSIONES: El diseño probabilístico de la Ensanut 100k permite hacer inferencias estadísticas válidas sobre parámetros de interés para la salud pública en localidades con menos de 100 000 habitantes, localidades donde vive 52% de la población según el censo de 2010. La comparabilidad de los resultados con la Ensanut 2012 facilita evaluar las acciones de apoyo que otorga el gobierno a poblaciones con menores capacidades económicas en el periodo 2012-2018.

Assuntos

RESUMO

Resumen: Objetivo: Describir el diseño metodológico de la Encuesta Nacional de Salud y Nutrición en localidades con menos de 100 000 habitantes (Ensanut 100k). Material y métodos: La Ensanut 100k es una encuesta probabilística que sobrerrepresenta a los hogares con menos capacidades económicas. Se describe el alcance de la encuesta, los procedimientos de muestreo, medición e inferencia y la organización logística. Resultados: Se obtuvieron 10 461 entrevistas de hogar y 26 161 de individuos. La tasa de respuesta de hogar fue 89% y de individuos 92%. Conclusiones: El diseño probabilístico de la Ensanut 100k permite hacer inferencias estadísticas válidas sobre parámetros de interés para la salud pública en localidades con menos de 100 000 habitantes, localidades donde vive 52% de la población según el censo de 2010. La comparabilidad de los resultados con la Ensanut 2012 facilita evaluar las acciones de apoyo que otorga el gobierno a poblaciones con menores capacidades económicas en el periodo 2012-2018.

Abstract: Objective: To describe the methodological design of the National Health and Nutrition Survey in localities with less than 100 000 inhabitants (Ensanut 100k). Materials and methods: The Ensanut 100k is a probabilistic survey that over-represents households with less economic capabilities. This paper describes the scope of the survey, sampling procedures, measurement and inference and logistics organization. Results: 10 461 home interviews and 26 161 individual interviews were obtained. The household response rate was 89 and 92% from individuals. Conclusions: The probabilistic design of the Ensanut 100k allows to make valid statistical inferences about parameters of interest for public health in localities with less than 100 000 inhabitants, localities where 52% of the population lives according to the 2010 census. The comparability of the results with the Ensanut 2012 facilitates the assessment of the government's support actions to populations with lower economic capacities in the period 2012-2018.

Assuntos

RESUMO

Resumo O objetivo deste artigo é analisar a tendência temporal do consumo de carnes gordurosas (CG) e fatores associados ao seu consumo habitual entre 2007 e 2014. Série temporal do consumo de CG (vermelha e frango/galinha) realizada a partir do inquérito telefônico "Vigilância de Fatores de Risco e Proteção para Doenças Crônicas" (Vigitel). A tendência do consumo foi analisada por regressão "joinpoint" e expressa em variação percentual anual (VPA[IC95%]), enquanto os fatores sociodemográficos e comportamentais associados em 2007 e 2014 por modelo linear generalizado (log-binomial). Entre 2007-2014, o consumo ≥ 5x/semana de carnes brancas aumentou (VPA 6,9% [5,7; 8,1]), enquanto as vermelhas permaneceu estável. O consumo CG apresentou redução significativa a partir de 2011 (VPA -4,0%[-7,5; -0,2]), provavelmente em função da redução no consumo das vermelhas gordurosas. Identificamos que o sexo masculino, as faixas etárias mais jovens, residir nas regiões CO/SE/S, escolaridade ≤ 8 anos e o uso abusivo de álcool e tabaco se associaram com o consumo de CG; assistir televisão > 3h/dia foi associada apenas em 2014. No período analisado houve redução no consumo de CG pela população brasileira, sendo seu consumo associado a fatores sociodemográficas e outros comportamentos promotores de DCNT.

Abstract The scope of this article is to analyze the temporal trend of the consumption of fatty meats and factors associated with the consumption thereof between 2007 and 2014. A time series of fatty meat consumption (red meat and chicken) was conducted by the "Surveillance of Risk and Protection Factors for Chronic Diseases (Vigitel) telephone survey." The consumption trend was analyzed by joinpoint regression and expressed in annual percentage variation (VPA [95% CI]), while sociodemographic and behavioral factors were associated in 2007 and 2014 by the generalized linear (log-binomial) model. Between 2007 and 2014, white meat consumption ≥ 5x/ week increased (VPA 6.9% [5.7, 8.1]), while red meat consumption remained stable. Fatty meat consumption showed a significant reduction as of 2011 (VPA -4% [-7.5; -0.2]), probably due to the reduction in the consumption of fatty red meats. It was found that males, of younger age groups living in the center-west/south-east/south regions, with low education level and alcohol and tobacco abuse were associated with fatty meat consumption; while watching television>3hours/day was only associated in 2014. The consumption of fatty meats showed a reduction trend in the Brazilian population, and its consumption was associated with sociodemographic and behavioral variables.

Assuntos

RESUMO

OBJECTIVES: To estimate the prevalence of multimorbidity and to identify factors associated with it in the adult population from the metropolitan region of Manaus. DESIGN: Cross-sectional population-based study. SETTING: Interviews conducted between May and August of 2015 in eight cities that compose the metropolitan region of Manaus, Amazonas, Brazil. PARTICIPANTS: 4001 adults aged ≥18 years. PRIMARY OUTCOME MEASURES: Multimorbidity, measured by the occurrence of ≥2 and ≥3 chronic diseases, was the primary outcome. The associated factors were investigated by calculating the prevalence ratio (PR) obtained by Poisson regression, with robust adjustment of the variance in a hierarchical model. A factor analysis was conducted to investigate multimorbidity clusters. RESULTS: Half of the interviewees were women. The presence of a chronic disease was reported by 57.2% (95% CI 56.6% to 59.7%) of the interviewees, and the mean morbidity was 1.2 (1.1-1.2); 29.0% (95% CI 27.6% to 30.5%) reported ≥2 morbidities and 15.2% (95% CI 14.1% to 16.4%) reported ≥3 chronic conditions. Back pain was reported by one-third of the interviewees. Multimorbidity was highest in women, PR=1.66 (95% CI 1.50 to 1.83); the elderly, PR=5.68 (95% CI 4.51 to 7.15) and individuals with worse health perception, PR=3.70 (95% CI 2.73 to 5.00). Associated factors also included undergoing medical consultations, hospitalisation in the last year, suffering from dengue in the last year and seeking the same healthcare service. Factor analysis revealed a pattern of multimorbidity in women. The factor loading the most strength of association in women was heart disease. In men, an association was identified in two groups, and lung disease was the disease with the highest factorial loading. CONCLUSION: Multimorbidity was frequent in the metropolitan region of Manaus. It occurred most often in women, in the elderly and in those with worse health perception.

Assuntos

RESUMO

Resumen: Objetivo: Actualizar las prevalencias de sobrepeso y obesidad (SP+O) y estudiar algunos determinantes asociados en población<20 años, de la Encuesta Nacional de Salud y Nutrición de Medio Camino 2016 (Ensanut MC 2016). Material y métodos: La Ensanut MC 2016 es una encuesta nacional probabilística. Se estimó el puntaje Z del índice de masa corporal. Se clasificó el riesgo de sobrepeso, sobrepeso y obesidad de acuerdo con el patrón de referencia de la OMS. Se estudiaron variables sociodemográficas asociadas con sobrepeso mediante regresión logística. Resultados: La prevalencia nacional de SP+O en <5 años fue niñas 5.8%, niños 6.5%; escolares niñas 32.8%, niños 33.7%; adolescentes mujeres 39.2% y hombres 33.5%. Las mujeres adolescentes de localidades rurales mostraron un incremento de 2012 a 2016 de 9.5 puntos porcentuales. Conclusiones: La prevalencia de SP+O en niñas y mujeres en zonas rurales muestran un aumento importante en un periodo corto, lo que llama a implementar acciones de atención inmediatas.

Abstract: Objective: To estimate recent overweight and obesity prevalences in Mexican population under 20 years from Halfway National Health and Nutrition Survey (Ensanut MC 2016). Materials and methods: Ensanut MC 2016 is a probabilistic national survey which gives representative information from national, regional and rural/urban levels. BMIz was estimated through weight and height, then it was classified into overweight risk or overweight or obesity according to WHO growth reference standards. Association between overweight and sociodemographic information was analyzed through logistic regression models. Results: Overweight-obesity prevalence was 5.1% in girls and 6.5% in boys<5y, 32.8% in girls and 33.7% in boys 5-11y, and 39.2% in female adolescents and 33.5% in male adolescents. Female adolescents from rural localities increased overweight-obesity prevalence from 27.7% in 2012 to 37.2% in 2016. Conclusions: Overweight-obesity increased in girls and females, mainly from rural areas. Strategies focused in containing this phenomenon are encouraged to implement in this context.

Assuntos

RESUMO

Resumo No final da década de 1980, um maior intercâmbio entre os escritórios regionais da OMS e ministros da saúde em todo o mundo fez surgir a necessidade de compatibilização das metodologias e instrumentos de coletas de dados para medir a situação de saúde, por intermédio de inquéritos populacionais, que pudessem complementar os registros de saúde pelos órgãos oficiais de estatística de cada País e tornar comparável os Sistemas Nacionais de Informação. Este artigo analisou as principais contribuições do Ministério da Saúde e do IBGE para a análise do estado de saúde da população brasileira. Delimitou-se como critério de inclusão, apenas as fontes de dados de domínio público, com periodicidade histórica, ao longo de pelo menos 20 anos e aqueles que geram dados municipais. Desse conjunto, foram analisadas as capitais do Brasil. Os dados demonstram a rápida transformação da rede pública de serviços de saúde sem internação, após a criação do Sistema Único de Saúde (SUS), passando de 40,7% (em 1986) para 85,5% (2009) o total de unidades de saúde públicas municipais sem internação. No Brasil, a iniciativa da RIPSA vem cumprindo o papel integrador para a formação de um Sistema Nacional de Informações em Saúde, preconizado pelo artigo 47 da Lei 8.080/1990 que instituiu o SUS, com grande responsabilidade do IBGE.

Abstract By the late 1980s, increased exchange between WHO regional offices and Health Ministers around the world raised the need for compatible methodologies and data collection tools to measure health status through population surveys, which could then complement the health records of the official statistics agencies in each country, and enabling comparison of National Information Systems. This article analyzes the main contributions of the Ministry of Health and the IBGE for the analysis of the health status of the Brazilian population. As a criterion for inclusion, only data sources in the public domain published periodically for at least the past 20 years, and those generating data at the municipal level were used. From this set, the capitals of Brazil were analyzed. The data shows that after the Unified Healthcare System (SUS) was created, the network of non-hospitalization healthcare experienced a rapid transformation. By 2009 85.5% of such units were under the municipal umbrella, compared to 40.7% when SUS was created. In Brazil, the RIPSA initiative has fulfilled the integrative role for the formation of a National Health Information System, recommended by Article 47 of Law 8.080 / 1990 that instituted the SUS, assigning major responsibility to1 the IBGE.

Assuntos