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Rocha SV, Alves Dos Santos C, Conceição AF, Palotino-Ferreira BM, Morais DB, Chavane FS, Chaves Dias CR, Lacerda Bachi AL, Mendes R, Brito-Costa S, Silva S, Furtado GE. Implementing regular physical activity for older individuals in the family strategy program using the RE-AIM framework to ensure feasibility and sustainability: EISI study protocol. Contemp Clin Trials Commun 2024; 39:101311. [PMID: 38881541 PMCID: PMC11179060 DOI: 10.1016/j.conctc.2024.101311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 05/21/2024] [Indexed: 06/18/2024] Open
Abstract
The EISI study protocol aims to address the low participation rate in physical exercise programs among older individuals, emphasizing its significance as a non-pharmacological therapeutic approach for overall health and increased physical activity. The objectives include implementing physical activity (PA) and educational health programs in Jequié, Bahia, Brazil, targeting the Family Health Strategy population to enhance local physical activity levels among older individuals. The study also seeks to evaluate the program's feasibility, safety, and sustainability for large-scale implementation, along with assessing its impact on immune and inflammatory response biomarkers to the SARS-CoV virus, as well as physical-functional and brain health. Participants, aged 60 or above, will be divided into two groups: multicomponent exercise (MCE) and behavioral change interventions (BCI). The study employs a mixed-method approach, utilizing a non-randomized controlled short-term pathway model for a 4-8 weeks of pilot study and 16-week intervention impact assessment. Data collection encompasses various aspects such as sociodemographic information, mental health, physical fitness, fall risk, functional capacity, anthropometric measurements, hemodynamic assessment, habitual physical activity, and health-related quality of life. Blood and saliva samples are collected for cytokine and antibody biomarker analysis related to SARS-CoV immunity. Pre- and post-intervention evaluations for both groups will be conducted, with the hypothesis that MCE will yield more favorable responses compared to BCI. The study's holistic approach, including the assessment of feasibility, safety, and sustainability, aims to contribute to achieving Sustainable Development Goals (SDG) 3 and SDG 9 b y promoting accessible and sustainable healthcare initiatives for older individuals. This research aligns with global efforts to enhance health and well-being, emphasizing the importance of regular exercise in the aging population.
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Affiliation(s)
- Saulo Vasconcelos Rocha
- State University of Southwest Bahia, Health Sector II, Av. José Moreira Sobrinho, S/n -Jequiezinho, 45205-490, Jequié, Bahia, Brazil
| | - Clarice Alves Dos Santos
- State University of Southwest Bahia, Health Sector II, Av. José Moreira Sobrinho, S/n -Jequiezinho, 45205-490, Jequié, Bahia, Brazil
| | - Ariani França Conceição
- State University of Southwest Bahia, Health Sector II, Av. José Moreira Sobrinho, S/n -Jequiezinho, 45205-490, Jequié, Bahia, Brazil
| | - Bruna Maria Palotino-Ferreira
- State University of Southwest Bahia, Health Sector II, Av. José Moreira Sobrinho, S/n -Jequiezinho, 45205-490, Jequié, Bahia, Brazil
| | - Danilo Barbosa Morais
- State University of Feira de Santana, Department of Health, Av. Transnordestino, S/n- Novo Horizonte, 44036-900, Feira de Santana, Bahia, Brazil
| | - Félix Salvador Chavane
- State University of Feira de Santana, Department of Health, Av. Transnordestino, S/n- Novo Horizonte, 44036-900, Feira de Santana, Bahia, Brazil
- Eduardo Mondlane University, Higher School of Sport Sciences, Av. Julius Nyerere, N. 3453- Main Campus, Maputo, Mozambique
| | - Carolina Rego Chaves Dias
- State University of Southwest Bahia, Health Sector II, Av. José Moreira Sobrinho, S/n -Jequiezinho, 45205-490, Jequié, Bahia, Brazil
| | - André Luís Lacerda Bachi
- Post-Graduation Program in Health Sciences, Santo Amaro University, Rua Prof. Enéas de Siqueira Neto, 340, 04829-300, São Paulo, Brazil
| | - Rui Mendes
- Polytechnic Institute of Coimbra, Coimbra Education School, Rua Dom João III - Solum, 3030-329, Coimbra, Portugal
- SPRINT - Sport Physical Activity and Health Research INvation cenTer, Rua Dom Joao III - Solum, 3030-329, Coimbra, Portugal
- Applied Research Uni in Sport Sciences, Coimbra Education School, Rua Dom Joao III - Solum, 3030-329, Coimbra, Portugal
| | - Sónia Brito-Costa
- Polytechnic Institute of Coimbra, Coimbra Education School, Rua Dom João III - Solum, 3030-329, Coimbra, Portugal
- Polytechnic Institute of Coimbra, Applied Research Institute, Rua da Misericórdia, Lagar Dos Cortiços - S. Martinho Do Bispo, 3045-093, Coimbra, Portugal
- NED - Center for Research and Innovation in Education, Polytechnic Institute of Coimbra Education School, Rua Dom Joao III - Solum, 3030-329, Coimbra, Portugal
| | - Sofia Silva
- Polytechnic Institute of Coimbra, Coimbra Education School, Rua Dom João III - Solum, 3030-329, Coimbra, Portugal
- NED - Center for Research and Innovation in Education, Polytechnic Institute of Coimbra Education School, Rua Dom Joao III - Solum, 3030-329, Coimbra, Portugal
| | - Guilherme Eustáquio Furtado
- SPRINT - Sport Physical Activity and Health Research INvation cenTer, Rua Dom Joao III - Solum, 3030-329, Coimbra, Portugal
- Polytechnic Institute of Coimbra, Applied Research Institute, Rua da Misericórdia, Lagar Dos Cortiços - S. Martinho Do Bispo, 3045-093, Coimbra, Portugal
- Research Centre for Natural Resources Environment and Society (CERNAS), Polytechnic Institute of Coimbra, Bencanta, 3045-601, Coimbra, Portugal
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Malta DC, Romero-Sandoval N, Cardoso LSDM, Arcos P, Gualán M, Pescarini JM, Brickley EB, Veloso GA, Bernal RTI, Gomes CS, Kerr LRFS, Naghavi M, Cooper PJ, Barreto ML, Leyland AH. Sustainable Development Goals' health-related indicators for Brazil and Ecuador: an analysis for the period of 1990-2019. Public Health 2024; 231:88-98. [PMID: 38653016 DOI: 10.1016/j.puhe.2024.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE This article aims to analyse the evolution of 40 Sustainable Development Goals' (SDGs) health-related indicators in Brazil and Ecuador from 1990 to 2019. STUDY DESIGN Epidemiological study of long-term trends in 40 SDGs' health-related indicators for Brazil and Ecuador from 1990 to 2019, using estimates from the Global Burden of Disease Study. METHODS Forty SDGs' health-related indicators and an index from 1990 to 2017 for Brazil and Ecuador, and their projections up to 2030 were extracted from the Institute for Health Metrics and Evaluation's Global Burden of Disease website and analysed. The percent annual change (PC) between 1990 and 2019 was calculated for both countries. RESULTS Both countries have made progress on child stunting (Brazil: PC = -38%; Ecuador: PC = -43%) and child wasting prevalences (Brazil: PC = -42%; Ecuador: PC = -41%), percent of vaccine coverage (Brazil: PC = +215%; Ecuador: PC = +175%), under-5 (Brazil: PC = -75%; Ecuador: PC = -60%) and neonatal mortality rates (Brazil: PC = -69%; Ecuador: PC = -51%), health worker density per 1000 population (Brazil: PC = +153%; Ecuador: PC = +175%), reduction of neglected diseases prevalences (Brazil: PC = -40%; Ecuador: PC = -58%), tuberculosis (Brazil: PC = -27%; Ecuador: PC = -55%) and malaria incidences (Brazil: PC = -97%; Ecuador: PC = -100%), water, sanitation and hygiene mortality rates (Brazil and Ecuador: PC = -89%). However, both countries did not show sufficient improvement in maternal mortality ratio to meet SDGs targets (Brazil: PC = -37%; Ecuador: PC = -40%). Worsening of indicators were found for violence, such as non-intimate partner violence for both countries (Brazil: PC = +26%; Ecuador: PC = +18%) and suicide mortality rate for Ecuador (PC = +66%), child overweight indicator for Brazil (PC = -67%), disaster mortality rates (Brazil: PC = +100%; Ecuador: PC = +325%) and alcohol consumption (Brazil: PC = +46%; Ecuador: PC = +35%). CONCLUSIONS Significant improvements are necessary in both countries requiring the strengthening of health and other policies, particularly concerning the prevention and management of violence and alcohol consumption, and preparedness for dealing with environmental disasters.
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Affiliation(s)
- D C Malta
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - N Romero-Sandoval
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador.
| | - L S de M Cardoso
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - P Arcos
- Universidad Internacional del Ecuador, Quito, Ecuador.
| | - M Gualán
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador.
| | - J M Pescarini
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom; Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Oswaldo Cruz Foundation, Salvador, Brazil.
| | - E B Brickley
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - G A Veloso
- Departamento de Estatística, Instituto de Matemática e Estatística, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
| | - R T I Bernal
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - C S Gomes
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - L R F S Kerr
- Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
| | - M Naghavi
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
| | - P J Cooper
- Institute of Infection and Immunity St. George's University of London. School of Medicine, Universidad Internacional del Ecuador, Ecuador.
| | - M L Barreto
- Centre for Data and Knowledge Integration for Health, Fiocruz Bahia, Salvador, Brazil.
| | - A H Leyland
- Social and Public Health Sciences Unit, University of Glasgow, United Kingdom.
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Malta DC, Saltarelli RMF, Veloso GA, Gomes CS, Soares Filho AM, Vieira EWR, Felisbino-Mendes MS, Naghavi M, Ribeiro ALP. Mortality by avoidable causes in Brazil from 1990 to 2019: data from the Global Burden of Disease Study. Public Health 2024; 227:194-201. [PMID: 38237315 DOI: 10.1016/j.puhe.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/07/2023] [Accepted: 12/06/2023] [Indexed: 02/18/2024]
Abstract
OBJECTIVES The aim of this study was to analyse the trends of avoidable mortality in Brazil from 1990 to 2019 and its correlation with sociodemographic indexes (SDIs). STUDY DESIGN Epidemiological mortality trends. METHODS This study analysed data from the Global Burden of Disease database. The list of causes of avoidable death, as proposed by Nolte and McKee, was applied and included 32 causes. The current study used age-standardised mortality rates and the rates of change, in addition to a correlation analysis between avoidable death and the SDI. RESULTS Mortality rates decreased from 343.90/100,000 inhabitants in 1990 to 155.80/100,000 inhabitants in 2019. Infectious diseases showed the largest decline in mortality rates, but notable decreases were also found for diarrhoeal diseases (-94.9%), maternal conditions (-66.5%) and neonatal conditions (-60.5%). Mortality rates for non-communicable diseases (NCDs) also decreased (-48%) but maintained a similar absolute number of deaths in 2019 compared with 1990. Decreased mortality rates were also found for ischaemic heart disease (-49.1%), stroke (-61.4%) and deaths due to adverse effects caused by medical treatments (-26.2%). Avoidable mortality rates declined in all of the 27 Brazilian states, and a high correlation was found between deaths and SDI (R = -0.74; P < 0.000001). CONCLUSIONS A reduction in avoidable deaths was found throughout Brazil over the study period, although major regional inequalities were revealed. Richer states presented the best overall reduction in mortality rates. The biggest decreases in mortality were seen in maternal and paediatric infectious diseases in the poorest states due to the expansion of the Primary Health System and improvements in sanitation. Today, NCDs predominate and efforts should be made to formulate public policies for the prevention and control of NCDs.
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Affiliation(s)
- D C Malta
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - R M F Saltarelli
- Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - G A Veloso
- Departamento de Estatística, Instituto de Matemática e Estatística, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - C S Gomes
- Programa de Pós-graduação em Saúde Pública, Faculdade de Medicina, Belo Horizonte, Minas Gerais, Brazil
| | - A M Soares Filho
- Programa de Pós-graduação em Saúde Pública, Faculdade de Medicina, Belo Horizonte, Minas Gerais, Brazil
| | - E W R Vieira
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - M S Felisbino-Mendes
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - M Naghavi
- University of Washington, Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - A L P Ribeiro
- Faculdade de Medicina, Hospital das Clínicas da UFMG, Belo Horizonte, Minas Gerais, Brazil
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Parajára MC, Colombet Z, Machado ÍE, Menezes MC, Verly-Jr E, O'Flaherty M, Meireles AL. Mortality attributable to diets low in fruits, vegetables, and whole grains in Brazil in 2019: evidencing regional health inequalities. Public Health 2023; 224:123-130. [PMID: 37774566 DOI: 10.1016/j.puhe.2023.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/08/2023] [Accepted: 08/06/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVE The objective of this study was to describe non-communicable disease (NCD) mortality attributable to diets low in whole grains, fruits, and vegetables in Brazil in 2019. STUDY DESIGN Ecological study. METHODS Data from the Global Burden of Disease 2019 for adults aged ≥25 years of both sexes in Brazil and its 27 states were used to estimate the intake of fruits, vegetables, and whole grains; the NCD mortality attributable to these dietary risk factors; and the correlation between socio-demographic index (SDI), the age-standardised mortality rate (ASMR) per 100,000 population, and intake. RESULTS The Brazilian population had suboptimal consumption of fruits, vegetables, and whole grains, and 62,439 NCD deaths were attributable to these three dietary risk factors in 2019. The highest ASMRs were found for diets low in whole grains (14.4, 95% uncertainty interval [95% UI]: 7.8-18.4), followed by diets low in vegetables (7.6, 95% UI: 4.8-10.3) and fruits (5.0, 95% UI: 3.2-7.0). A similar ranking was observed for all Brazilian states. The SDI was negatively correlated with ASMRs and was positively correlated with the investigated dietary risks. The population from the Northeast and North states presented the lowest SDI and the highest NCD ASMRs attributable to diets low in fruits, vegetables, and whole grains and consumed less of all three health foods. CONCLUSION Diets low in fruits, vegetables, and mainly whole grains substantially contributed to NCD mortality in Brazil, especially in states with low SDI. Our findings support the need to target food interventions to reduce regional health inequalities within the country.
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Affiliation(s)
- M C Parajára
- Postgraduate Program in Health and Nutrition, School of Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil
| | - Z Colombet
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Í E Machado
- Postgraduate Program in Health and Nutrition, School of Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil; Department of Family Medicine, Mental and Collective Health, Medical School, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil
| | - M C Menezes
- Postgraduate Program in Health and Nutrition, School of Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil; Department of Clinical and Social Nutrition, School of Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil
| | - E Verly-Jr
- Department of Epidemiology, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - M O'Flaherty
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - A L Meireles
- Postgraduate Program in Health and Nutrition, School of Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil; Department of Clinical and Social Nutrition, School of Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil.
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Parajára MDC, Machado ÍE, Verly-Junior E, Menezes MCD, Nilson EAF, Meireles AL. Burden of ischemic heart disease attributable to trans fatty acids, 1990-2019. Clin Nutr ESPEN 2023; 57:272-280. [PMID: 37739668 DOI: 10.1016/j.clnesp.2023.06.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 06/13/2023] [Accepted: 06/30/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND & AIM The impact of cardiovascular disease attributable to trans fatty acids (TFAs) in the Brazilian population has not been systematically evaluated. This study aims to analyze the burden of ischemic heart disease (IHD) attributable to TFAs in Brazil between 1990 and 2019. METHODS Data from the Global Burden of Disease Study 2019 were used to investigate the attributable burden in Brazil and its 27 federative units, for both sexes-pooled adults aged ≥25 years. Mortality and disability-adjusted life years (DALYs) from IHD attributable to TFAs were expressed as crude and age-standardized rates and differences from 1990 to 2019 by percentage and annualized rate of change. Linear regression was used to investigate trends. National voluntary and regulatory policies for industrial TFAs (iTFAs) implemented until 2019, summary exposure value (SEV) and sociodemographic index (SDI) were examined. RESULTS Between 1990 and 2019, crude and age-standardized mortality rates from IHD attributable to TFAs decreased by -15.9% and -58.0%, respectively, in Brazil. A decrease in crude (-23.3%) and age-standardized (-56.4%) DALY rates of IHD attributable to TFAs was also noticed in the country. States of the South, Southeast, and the Federal District had the largest declines of IHD attributable to TFAs, while states of the Northeast and North had the smallest or even an increase. The policies already adopted had little effect on the IHD burden. A lower SEV and higher SDI value seemed to reduce the burden of IHD. CONCLUSIONS Although a downward trend in IHD attributable to TFAs and a reduction in exposure to TFAs were observed, this burden is still relevant in Brazil, reinforcing the importance of diet policies, such as banning iTFAs.
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Affiliation(s)
- Magda do Carmo Parajára
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Ísis Eloah Machado
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Department of Family Medicine, Mental and Collective Health, Medical School, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Eliseu Verly-Junior
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariana Carvalho de Menezes
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Department of Clinical and Social Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | | | - Adriana Lúcia Meireles
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Department of Clinical and Social Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil.
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Marques GS, Almeida AM, Gomes IC, Silva MRBD, Rezende BA. Primary care in supplementary health: assessment of costs in the care of older adult patients with heart diseases. Rev Bras Enferm 2023; 76:e20220486. [PMID: 37436234 DOI: 10.1590/0034-7167-2022-0486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 01/09/2023] [Indexed: 07/13/2023] Open
Abstract
OBJECTIVES to identify whether implementing a supplementary Primary Health Care (PHC) system makes it possible to reduce care costs for older adults with heart diseases. METHODS a retrospective cohort of 223 patients with heart disease aged ≥ 60 years. Data were obtained from medical records and cost databases, assessed for a period of one year before and after PHC implementation. The results were expressed as mean absolute frequencies for number of hospitalizations and as average annual expenses expressed in dollars (US$) in relation to cost data. RESULTS there was a reduction in hospitalization expenses after implementing supplementary PHC (p=0.01) and a decrease in the frequency of hospitalizations for the entire sample (p=0.006). There was a reduction in the frequency of consultations at the Emergency Room among frail older adults (p=0.011). CONCLUSIONS there was a reduction in hospitalization costs and frequency of visits to the Emergency Room after supplementary PHC.
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Affiliation(s)
- Geórgia Silva Marques
- Faculdade de Ciências Médicas. Belo Horizonte, Minas Gerais, Brazil
- Fundação São Francisco Xavier. Ipatinga, Minas Gerais, Brazil
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Rotta I, Lima T, Tonin FS. Role of community pharmacy and pharmacists in self-care in Brazil. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 10:100274. [PMID: 37181500 PMCID: PMC10173763 DOI: 10.1016/j.rcsop.2023.100274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 05/16/2023] Open
Abstract
Global healthcare systems, including the National Health System in Brazil - one of the largest public models in the world -, continue to evolve, as well as populations' health needs, currently shaped on individuals feeling a greater desire to manage their own health. Self-care practices are part of several public policies and clinical guidelines in Brazil including the National Policy on Complementary and Integrative Practices, the National AIDS Control Program, the National Policy for Women's Health, and the Guidelines for Care of People with Chronic Diseases. There are over 100,700 community pharmacies, in the country (89.2% privately owned) employing 234,300 pharmacists, representing an important delivery point for self-care, as they are the first point of access to care for most patients. Self-medication is a common practice in Brazil (prevalence rates of self-medication ranging from 16.1% to 35.0%), especially with non-prescription/over-the-counter medicinal products (65.0%). In fact, these products represent over 25% of volume marketed of medicines, summing revenues of USD 1.9 billion per year. Studies demonstrated a positive budget impact as important savings for the National Health System due to reductions of unnecessary medical appointments and loss of working days. In addition to minor ailments management, other self-care services provided by community pharmacies that are frequently sought by Brazilian citizens (20-25% of cases) are smoking cessation and weight management (costs per service ranging from around USD 5.00-12.00). However, pharmacy services are not yet as fully integrated in Brazil to the same extent as in other countries. Barriers such as standardization of processes (from services' design, implementation, and evaluation in practice), pharmacist remuneration for the provision of services and the amount to be charged for the service are still a matter of controversy. For more rapid and sustainable advances in these practices, communication among various stakeholders, professional practice and healthcare regulations, standardization of services and financing of self-care (both publicly and privately) are urgently needed. This paper provides an overview of some self-care services provided by community pharmacies in Brazil and call attention to the ongoing challenges to move the National Health system forward.
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Affiliation(s)
- Inajara Rotta
- Department of Pharmacy, Federal University of Paraná, Curitiba, Brazil
| | - Tácio Lima
- Department of Pharmaceutical Sciences, Federal Rural University of Rio de Janeiro, Seropedica, Brazil
| | - Fernanda S. Tonin
- Pharmaceutical Sciences Postgraduate Research Program, Federal University of Paraná, Curitiba, Brazil
- H&TRC - Health & Technology Research Center, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
- Corresponding author at: H&TRC - Health & Technology Research Center, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096 Lisbon, Portugal.
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Leal JSV, Fogal AS, Meireles AL, Cardoso LDO, Machado ÍE, de Menezes MC. Health economic impacts associated with the consumption of sugar-sweetened beverages in Brazil. Front Nutr 2022; 9:1088051. [PMID: 36601075 PMCID: PMC9806132 DOI: 10.3389/fnut.2022.1088051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction The consumption of sugar-sweetened beverages (SSBs) is among the main risk factors for non-communicable diseases (NCDs). This study aimed to estimate the financial costs of hospitalizations and procedures of high and medium complexity for NCDs attributable to the consumption of SSBs in the Brazilian Unified Health System (SUS) in 2019. Methods This ecological study used data from the Global Burden of Disease (GBD) 2019 and the Department of Informatics of the Unified Health System (DATASUS). The attributable costs were estimated from the population-attributable fraction (PAF) and the costs in the treatment of chronic diseases [type 2 diabetes mellitus and ischemic heart disease (IHD)], stratified by sex, age group, level of complexity of treatment, and federative units. Results In 2019, in Brazil, US$ 14,116,240.55 were the costs of hospitalizations and procedures of high and medium complexity in the treatment of NCDs attributable to the consumption of SSBs. These values were higher in males (US$ 8,469,265.14) and the southeast and southern regions, mainly in the state of São Paulo. However, when evaluating these results at a rate per 10,000 inhabitants, it was observed that the states of Paraná, Tocantins, and Roraima had higher costs per 10,000 inhabitants. Regarding the age groups, higher costs were observed in the older age groups. Conclusion This study revealed the high financial impact of the NCDs treatment attributed to the consumption of SSBs in Brazil and the variability among Brazilian macro-regions. The results demonstrate the urgency and need for the expansion of policies to reduce the consumption of SSBs in Brazil with strategies that consider regional particularities.
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Affiliation(s)
- Joice Silva Vieira Leal
- Graduate Program in Health and Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Aline Siqueira Fogal
- Graduate Program in Health and Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Adriana Lúcia Meireles
- Graduate Program in Health and Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil,Department of Clinical and Social Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Letícia de Oliveira Cardoso
- Department of Epidemiology, Oswaldo Cruz Foundation, National School of Public Health Sérgio Arouca (ENSP), Quantitative Methods in Health, Rio de Janeiro, Brazil
| | - Ísis Eloah Machado
- Graduate Program in Health and Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil,Department of Family Medicine, Mental and Collective Health, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Mariana Carvalho de Menezes
- Graduate Program in Health and Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil,Department of Clinical and Social Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil,*Correspondence: Mariana Carvalho de Menezes,
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9
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Pescarini JM, Campbell D, Amorim LD, Falcão IR, Ferreira AJF, Allik M, Shaw RJ, Malta DC, Ali MS, Smeeth L, Barreto ML, Leyland A, Craig P, Aquino EML, Katikireddi SV. Impact of Brazil's Bolsa Família Programme on cardiovascular and all-cause mortality: a natural experiment study using the 100 Million Brazilian Cohort. Int J Epidemiol 2022; 51:1847-1861. [PMID: 36172959 PMCID: PMC9749722 DOI: 10.1093/ije/dyac188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/13/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) has a disproportionate effect on mortality among the poorest people. We assessed the impact on CVD and all-cause mortality of the world's largest conditional cash transfer, Brazil's Bolsa Família Programme (BFP). METHODS We linked administrative data from the 100 Million Brazilian Cohort with BFP receipt and national mortality data. We followed individuals who applied for BFP between 1 January 2011 and 31 December 2015, until 31 December 2015. We used marginal structural models to estimate the effect of BFP on all-age and premature (30-69 years) CVD and all-cause mortality. We conducted stratified analyses by levels of material deprivation and access to healthcare. We checked the robustness of our findings by restricting the analysis to municipalities with better mortality data and by using alternative statistical methods. RESULTS We studied 17 981 582 individuals, of whom 4 855 324 were aged 30-69 years. Three-quarters (76.2%) received BFP, with a mean follow-up post-award of 2.6 years. We detected 106 807 deaths by all causes, of which 60 893 were premature; and 23 389 CVD deaths, of which 15 292 were premature. BFP was associated with reductions in premature all-cause mortality [hazard ratio (HR) = 0.96, 95% CI = 0.94-0.98], premature CVD (HR = 0.96, 95% CI = 0.92-1.00) and all-age CVD (HR = 0.96, 95% CI = 0.93-1.00) but not all-age all-cause mortality (HR = 1.00, 95% CI = 0.98-1.02). In stratified and robustness analyses, BFP was consistently associated with mortality reductions for individuals living in the two most deprived quintiles. CONCLUSIONS BFP appears to have a small to null effect on premature CVD and all-cause mortality in the short term; the long-term impact remains unknown.
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Affiliation(s)
- Julia M Pescarini
- Corresponding author. London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK. E-mail:
| | - Desmond Campbell
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Leila D Amorim
- Departamento de Estatística, Instituto de Matemática e Estatística, Universidade Federal da Bahia, Salvador, Brazil
| | - Ila R Falcão
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Andrêa J F Ferreira
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Mirjam Allik
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Richard J Shaw
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Deborah C Malta
- Departamento materno infantil e saude pública, Universidade Federal de Minas gerais (UFMG), Belo Horizonte, Brazil
| | - M Sanni Ali
- Departments of Infectious Disease Epidemiology (JMP) and Epidemiology and Population Health (LS), Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Liam Smeeth
- Departments of Infectious Disease Epidemiology (JMP) and Epidemiology and Population Health (LS), Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK,Health Data Research (HDR), London, UK
| | - Mauricio L Barreto
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil,Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Alastair Leyland
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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10
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Camoni N, Cirio S, Salerno C, Balian A, Bruni G, D’Avola V, Cagetti MG. COVID-19 Pandemic and Remote Consultations in Children: A Bibliometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9787. [PMID: 36011421 PMCID: PMC9407809 DOI: 10.3390/ijerph19169787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/04/2022] [Accepted: 08/06/2022] [Indexed: 06/15/2023]
Abstract
Telemedicine is becoming a standard method of consultation, and the COVID-19 pandemic has increased its need. Telemedicine is suitable for non-communicable diseases (NCDs) in the pediatric population, as these are chronic conditions that affect many children worldwide. The aim of this study was to analyze the bibliometric parameters of publications on the use of telemedicine for the most common NCDs in children before and after the COVID-19 pandemic. Following the electronic search, 585 records were selected. "Metabolic diseases" was the most frequent topic before and after the pandemic, accounting for 34.76% in 2017-2019 and 33.97% in 2020-2022. The average IF of the journals from which records were retrieved was 5.46 ± 4.62 before and 4.58 ± 2.82 after the pandemic, with no significant variation. The number of citations per reference averaged 14.71 ± 17.16 in 2017-2019 (95% CI: 12.07; 17.36) and 5.54 ± 13.71 in 2020-2022 (95% CI: 4.23; 6.86). Asthma, metabolic diseases, and neurodevelopmental disorders were the most explored topics. A relevant finding concerns the increasing number of observational studies after the pandemic, with a reduction of the interventional studies. The latter type of study should be recommended as it can increase the evaluation of new strategies for the management of NCDs.
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Affiliation(s)
- Nicole Camoni
- Department of Restorative, Preventive and Paediatric Dentistry, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Silvia Cirio
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Claudia Salerno
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Araxi Balian
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Dental and Stomatology Unit, Cittadella Hospital, AULSS 6 Euganea, 35013 Cittadella, Italy
| | - Giulia Bruni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Valeria D’Avola
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Maria Grazia Cagetti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
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11
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Leal JSV, Vegi ASF, Meireles AL, Machado ÍE, Menezes MCD. Burden of non-communicable chronic diseases attributable to the consumption of sugar-sweetened beverage, 1990–2019. Clin Nutr ESPEN 2022; 51:253-261. [DOI: 10.1016/j.clnesp.2022.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 08/11/2022] [Accepted: 08/14/2022] [Indexed: 11/24/2022]
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12
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Wehrmeister FC, Wendt AT, Sardinha LM. Inequalities and Chronic Non-Communicable Diseases in Brazil. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2022; 31:e20211065. [PMID: 35830089 PMCID: PMC9897814 DOI: 10.1590/ss2237-9622202200016.especial] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Fernando C. Wehrmeister
- Universidade Federal de Pelotas, Programa de Pós-Graduação em
Epidemiologia, Pelotas, RS, Brazil
| | - Andrea T. Wendt
- Universidade Federal de Pelotas, Programa de Pós-Graduação em
Epidemiologia, Pelotas, RS, Brazil
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13
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Francisco PMSB, Assumpção DD, Bacurau AGDM, Neri AL, Malta DC, Borim FSA. Prevalence of chronic diseases in octogenarians: data from the National Health Survey 2019. CIENCIA & SAUDE COLETIVA 2022; 27:2655-2665. [PMID: 35730836 DOI: 10.1590/1413-81232022277.22482021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/21/2021] [Indexed: 11/21/2022] Open
Abstract
This article aims to estimate the prevalence of chronic diseases/conditions in octogenarians according to sex, age groups and private health insurance, and its relationship with difficulty in performing usual activities. Cross-sectional population-based study with elderly data (n = 6,098) from the National Health Survey (PNS) 2019. Prevalences and 95% confidence intervals were estimated. The prevalences were: hypertension 61.7%, chronic back problem 30.0%, hypercholesterolemia 22.0%, diabetes 20.3%; arthritis/rheumatism 19.4%, heart disease 19.3%, depression 9.4%, cancer 8.9%, cerebrovascular accident (CA) 7.5%, asthma 4.9%, lung disease (LD) 4.2% and kidney failure (KF) 3.0%. Hypertension, chronic back problem, hypercholesterolemia, major arthritis/rheumatism and depression in women, and cancer in men. Major heart disease, hypercholesterolemia, arthritis/rheumatism, KF, cancer and depression in those with private health insurance. Restriction of usual activities 14.8%, more frequent in cardiac patients, with chronic back problem, arthritis/rheumatism, KF, depression, CA, cancer and LD. There were higher prevalences in women and in those who have health insurance. Difficulties in usual activities related to diseases demand the expansion of care for the older adults.
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Affiliation(s)
| | - Daniela de Assumpção
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária. 13083-887 Campinas SP Brasil.
| | - Aldiane Gomes de Macedo Bacurau
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária. 13083-887 Campinas SP Brasil.
| | - Anita Liberalesso Neri
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária. 13083-887 Campinas SP Brasil.
| | | | - Flávia Silva Arbex Borim
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária. 13083-887 Campinas SP Brasil. .,Faculdade de Ciências da Saúde, Universidade de Brasília. Brasília DF Brasil
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14
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Ferreira Silva RM, Mendonça CR, Azevedo VD, Raoof Memon A, Noll PRES, Noll M. Barriers to high school and university students' physical activity: A systematic review. PLoS One 2022; 17:e0265913. [PMID: 35377905 PMCID: PMC8979430 DOI: 10.1371/journal.pone.0265913] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
Physical inactivity commonly occurs throughout one's life, particularly during adolescence and young adulthood. Multiple factors can negatively influence participation in physical activity, but there has been no review examining the barriers to physical activity among high school and university students. Therefore, the aim of this systematic review was to summarize evidence of barriers to the practice of physical activity among high school and university students. The literature search was conducted without time limits using five databases, including CINAHL, Cochrane Library, Embase, PubMed, and Scopus. In total, 59 studies (37 with high school students [n = 22,908] and 22 with university students [n = 15,411]) were included. The main barriers identified in high school and university students were lack of time, lack of motivation, and lack of accessible places. These findings may be useful in designing and implementing evidence-informed interventions and programs for physical activity promotion in students.
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Affiliation(s)
| | | | | | - Aamir Raoof Memon
- Institute of Physiotherapy and Rehabilitation Sciences, Peoples University of Medical and Health Sciences for Women, Nawabshah (Shaheed Benazirabad), Pakistan
| | | | - Matias Noll
- Federal Institute Goiano, Ceres, Goiás, Brazil
- Federal University of Goiás, Goiânia, Goiás, Brazil
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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15
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Leal LF, Malta DC, Souza MDFM, Vasconcelos AMN, Teixeira RA, Veloso GA, Lansky S, Ribeiro ALP, de França GVA, Naghavi M. Maternal Mortality in Brazil, 1990 to 2019: a systematic analysis of the Global Burden of Disease Study 2019. Rev Soc Bras Med Trop 2022; 55:e0279. [PMID: 35107531 PMCID: PMC9009438 DOI: 10.1590/0037-8682-0279-2021] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/23/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Maternal death continues to be one of the most challenging public health problems that needs to be addressed in low and middle-income countries. The objective of this study was to describe the problem of maternal death in Brazil, using estimates from the Global Burden of Disease Study (GBD). METHODS This study used data from the GBD 2019 to show the numbers of deaths and the Maternal Mortality Ratio (MMR) - number of deaths/100,000 live births - in Brazil and its 27 Federated Units (FU), for ages 10 to 54 years, from 1990 to 2019. The annual variation of the MMR was estimated in 1990, 2010, and 2019. The MMR were shown for specific causes as well as for five-year age groups. The estimates were presented with 95% uncertainty intervals (UI). RESULTS The number of maternal deaths, as well as the MMR showed a 49% reduction from 1990 to 2019. This reduction occurred heterogeneously throughout the country, and the profile of the MMR for specific causes changed between 1990 and 2019: from hypertensive gestation diseases, to indirect maternal deaths, followed by hypertensive gestation diseases. In the extreme age groups, the MMR is higher, with mortality increasing exponentially in direct proportion with age. CONCLUSIONS Maternal deaths in Brazil have decreased substantially since 1990; however, the numbers still fall short of what was established by the World Health Organization (WHO). Indirect causes are the greatest problem in more than 60% of the FU, especially for hypertensive pregnancy diseases.
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Affiliation(s)
- Lisiane Freitas Leal
- McGill University, Department of Epidemiology, Biostatistics and Occupational Health, Montreal, QC, Canada
| | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Belo Horizonte, MG, Brasil
| | - Maria de Fatima Marinho Souza
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Análise da Situação de Saúde, Brasília, DF, Brasil
| | - Ana Maria Nogales Vasconcelos
- Universidade de Brasília - Campus Darcy Ribeiro, Departamento de Estatística, Instituto de Ciências Exatas, Brasília, DF, Brasil
| | - Renato Azeredo Teixeira
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública, Belo Horizonte, MG, Brasil
| | - Guilherme Augusto Veloso
- Universidade Federal de Minas Gerais, Departamento de Estatística, Programa de Pós-graduação em Estatística, Belo Horizonte, MG, Brasil
| | - Sônia Lansky
- Secretaria Municipal de Saúde Belo Horizonte, Belo Horizonte, MG, Brasil
| | - Antonio Luiz Pinho Ribeiro
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte, MG, Brasil
| | | | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, Seattle, WA, United States of America
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16
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Brant LCC, Nascimento BR, Veloso GA, Gomes CS, Polanczyk C, de Oliveira GMM, Flor LS, Gakidou E, Ribeiro ALP, Malta DC. Burden of Cardiovascular diseases attributable to risk factors in Brazil: data from the "Global Burden of Disease 2019" study. Rev Soc Bras Med Trop 2022; 55:e0263. [PMID: 35107526 PMCID: PMC9009428 DOI: 10.1590/0037-8682-0263-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/05/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION To better understand trends in the main cause of death in Brazil, we sought to analyze the burden of cardiovascular risk factors (RF) and cardiovascular diseases (CVD) attributable to specific RFs in Brazil from 1990 to 2019, using the estimates from the GBD 2019 study. METHODS To estimate RF exposure, the Summary Exposure Value (SEV) was used, whereas for disease burden attributed to RF, mortality and disability-adjusted life-years (DALY) due to CVD were used. For comparisons over time and between states, we compared age-standardized rates. The sociodemographic index (SDI) was used as a marker of socioeconomic conditions. RESULTS In 2019, 83% of CVD mortality in Brazil was attributable to RF. For SEV, there was a reduction in smoking and environmental RF, but an increase in metabolic RF. High systolic blood pressure and dietary risks continue to be the main RF for CVD mortality and DALY. While there was a decline in age-standardized mortality rates attributable to the evaluated RF, there was also a stability or increase in crude mortality rates, with the exception of smoking. It is important to highlight the increase in the risk of death attributable to a high body mass index. Regarding the analysis per state, SEVs and mortality attributable to RF were higher in those states with lower SDIs. CONCLUSIONS Despite the reduction in CVD mortality and DALY rates attributable to RF, the stability or increase in crude rates attributable to metabolic RFs is worrisome, requiring investments and a renewal of health policies.
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Affiliation(s)
- Luisa Campos Caldeira Brant
- Universidade Federal de Minas Gerais, Faculdade de Medicina e Hospital das Clínicas, Belo Horizonte, MG, Brasil
| | - Bruno Ramos Nascimento
- Universidade Federal de Minas Gerais, Faculdade de Medicina e Hospital das Clínicas, Belo Horizonte, MG, Brasil
| | - Guilherme Augusto Veloso
- Universidade Federal de Minas Gerais, Departamento de Estatística, Programa de Pós-Graduação em Estatística, Belo Horizonte, MG, Brasil
| | - Crizian Saar Gomes
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Medicina Preventiva e Social, Programa de Pós-Graduação em Saúde Pública, Belo Horizonte, MG, Brasil
| | - Carisi Polanczyk
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, RS, Brasil
| | | | - Luisa Sorio Flor
- University of Washington, Institute of Health Metrics and Evaluation, Seattle, USA
| | - Emmanuela Gakidou
- University of Washington, Institute of Health Metrics and Evaluation, Seattle, USA
| | - Antonio Luiz Pinho Ribeiro
- Universidade Federal de Minas Gerais, Faculdade de Medicina e Hospital das Clínicas, Belo Horizonte, MG, Brasil
| | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Belo Horizonte, MG, Brasil
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Stopa SR, Szwarcwald CL, Oliveira MMD, Andrade SSCDA. Vigilância das Doenças Crônicas Não Transmissíveis: reflexões sobre o papel dos inquéritos nacionais de saúde do Brasil. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2022. [DOI: 10.1590/ss2237-9622202200013.especial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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18
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Francisco PMSB, Assumpção DD, Bacurau AGDM, Neri AL, Malta DC, Borim FSA. Prevalence of chronic diseases in octogenarians: data from the National Health Survey 2019. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-81232022277.22482021en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract This article aims to estimate the prevalence of chronic diseases/conditions in octogenarians according to sex, age groups and private health insurance, and its relationship with difficulty in performing usual activities. Cross-sectional population-based study with elderly data (n = 6,098) from the National Health Survey (PNS) 2019. Prevalences and 95% confidence intervals were estimated. The prevalences were: hypertension 61.7%, chronic back problem 30.0%, hypercholesterolemia 22.0%, diabetes 20.3%; arthritis/rheumatism 19.4%, heart disease 19.3%, depression 9.4%, cancer 8.9%, cerebrovascular accident (CA) 7.5%, asthma 4.9%, lung disease (LD) 4.2% and kidney failure (KF) 3.0%. Hypertension, chronic back problem, hypercholesterolemia, major arthritis/rheumatism and depression in women, and cancer in men. Major heart disease, hypercholesterolemia, arthritis/rheumatism, KF, cancer and depression in those with private health insurance. Restriction of usual activities 14.8%, more frequent in cardiac patients, with chronic back problem, arthritis/rheumatism, KF, depression, CA, cancer and LD. There were higher prevalences in women and in those who have health insurance. Difficulties in usual activities related to diseases demand the expansion of care for the older adults.
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Malta DC, Bernal RTI, Lima MG, Silva AGD, Szwarcwald CL, Barros MBDA. Socioeconomic inequalities related to noncommunicable diseases and their limitations: National Health Survey, 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210011. [PMID: 34910065 DOI: 10.1590/1980-549720210011.supl.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/26/2021] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE to analyze socioeconomic inequalities in the self-reported prevalence of NonCommunicable Diseases (NCDs) and their disabilities in the Brazilian adult population. METHODS Cross-sectional study with data from the National Health Survey carried out in 2019. The self-reported prevalences of individuals with some noncommunicable diseases were calculated, according to sociodemographic characteristics; and the prevalence and prevalence ratio of these diseases and degrees of disability, according to education and possession of a private health plan. RESULTS 47.6% of the population reported having at least one noncommunicable diseases. Noncommunicable diseases increased progressively with age and were more prevalent in women (PR 1.13; 95%CI 1.1-1.15), in black (PR 1.04; 95%CI 1.01-1, 06) or brown individuals (PR 1.05; 95%CI 1.01-1.09), illiterate or with incomplete elementary education (PR 1.12; 95%CI 1.08-1.16), in the Southeast (PR 1.10; 95%CI 1.05-1.14) and the South (PR 1.07; 95%CI 1.03-1.12) and among individuals who do not have private health insurance (PR 1.02; 95%CI 1.0-1.05). For the majority of noncommunicable diseases investigated, the highest reports of disabilities were among those with low education and without health insurance. CONCLUSION adults with less education and without private health plans have a higher prevalence of noncommunicable diseases and a higher degree of disability. Thus, it is important to analyze health indicators in the face of different populations and disparities, in order to understand and monitor health inequalities.
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Affiliation(s)
- Deborah Carvalho Malta
- Postgraduate Program in Nursing, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Regina Tomie Ivata Bernal
- Postgraduate Program in Nursing, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | | | - Alanna Gomes da Silva
- Postgraduate Program in Nursing, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Célia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brazil
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Malta DC, Gomes CS, Prates EJS, Santos FPD, Almeida WDSD, Stopa SR, Pereira CA, Szwarcwald CL. Analysis of demand and access to services in the last two weeks previous to the National Health Survey 2013 and 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210002. [PMID: 34910056 DOI: 10.1590/1980-549720210002.supl.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/16/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Compare the demand and use of health services between 2013 and 2019, and analyze the associated sociodemographic and health variables in 2019. METHODS Cross-sectional study with data from the National Health Survey (PNS) 2013 and 2019. The prevalence and 95% confidence intervals (95% CI) for the demand and use of health services were estimated. In 2019, the differences in the indicators were analyzed according to sociodemographic variables and the crude and adjusted by sex and age prevalence ratios (RP) were estimated. RESULTS There was an increase of 22% in the demand for health care in the last two weeks, going from 15.3% (95%CI 15.0-15.7) in 2013 to 18.6% (95%CI 18.3-19.0) in 2019. There was a reduction in use in the last two weeks, from 97% (95%CI 96.6-97.4) in 2013 to 86.1% (95%CI 85.4-86.8) in 2019, which was observed for most Federation Units. In 2019, the demand for care was greater among women, the elderly, those with high schooling, individuals with health insurance and poor self-rated health. They obtained greater access to health services in the fifteen days prior to the survey: men, children or adolescents up to 17 years of age, people with health insurance and poor health self-assessment. CONCLUSION The demand for health services has grown and reduced access in the last 15 days between 2013 and 2019. These differences may have been exacerbated by the austerity measures implemented in the country.
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Affiliation(s)
- Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Crizian Saar Gomes
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | | | | | - Wanessa da Silva de Almeida
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brazil
| | - Sheila Rizzato Stopa
- Department of Health Analysis and Surveillance of Chronic Non-communicable Diseases, Secretariat of Health Surveillance, Ministry of Health - Brasília (DF), Brazil
| | - Cimar Azeredo Pereira
- Directorate of Research, Instituto Brasileiro de Geografia e Estatística - Rio de Janeiro (RJ), Brazil
| | - Célia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brazil
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21
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Malta DC, Bernal RTI, Gomes CS, Cardoso LSDM, Lima MG, Barros MBDA. Inequalities in the use of health services by adults and elderly people with and without noncommunicable diseases in Brazil, 2019 National Health Survey. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210003. [PMID: 34910057 DOI: 10.1590/1980-549720210003.supl.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/26/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The objective of this study was to investigate the use of health services and limitations in performing usual activities by adults and elderly people with and without noncommunicable chronic diseases (NCDs), according to sociodemographic strata. METHODS This is a cross-sectional study in which data from the 2019 National Health Survey were analyzed. The final sample corresponded to 88,531 households with interviews carried out, referring to individuals aged 18 years and above. The prevalence of use of services by the population with NCDs was compared with that of the population without NCDs and stratified by socioeconomic and demographic variables. Prevalence ratios (PRs) and 95% confidence intervals (95%CI) were calculated. RESULTS In 2019, 47.6% (95%CI 47.0-48.3) of the population reported having one or more NCDs. Population with NCDs had more medical consultations in the last 12 months (adjusted PR [APR]=1.21; 95%CI 1.20-1.23), used more health services in the last 2 weeks (APR=2.01; 95%CI 1.91-2.11), were referred to more hospitalization (APR=2.11; 95%CI 1.89-2.36), and had more limitations in performing usual activities (APR=2.52; 95%CI 2.30-2.76), compared with the population without NCDs. A positive dose-response gradient was observed between the number of comorbidities and the use of services. In all socioeconomic and demographic strata, the prevalence of indicators was higher in people with NCDs. CONCLUSION The presence of NCDs was associated with a higher frequency of use of health services (i.e., consultation, use of services, and hospitalization) and the restriction of usual activities in all socioeconomic and demographic strata.
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Affiliation(s)
- Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil.,Postgraduate Program in Public Health, Faculty of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Regina Tomie Ivata Bernal
- Postgraduate Program in Nursing, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Crizian Saar Gomes
- Postgraduate Program in Public Health, Faculty of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | | | - Margareth Guimarães Lima
- Department of Collective Health, Faculty of Medical Sciences, Universidade de Campinas - Campinas (SP), Brazil
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22
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Malta DC, Gomes CS, Andrade FMDD, Prates EJS, Alves FTA, Oliveira PPVD, Freitas PCD, Pereira CA, Caixeta RDB. Tobacco use, cessation, secondhand smoke and exposure to media about tobacco in Brazil: results of the National Health Survey 2013 and 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210006. [PMID: 34910060 DOI: 10.1590/1980-549720210006.supl.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/26/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To compare indicators of tobacco use, secondhand smoke, cessation and exposure to pro- and anti-tobacco media in 2013 and 2019, and to describe these indicators according to sociodemographic variables in 2019. METHODS Cross-sectional study with data from the National Health Survey. The indicators of use, secondhand smoke, cessation and exposure to tobacco-related media were evaluated. Prevalence and confidence intervals (95%CI) were estimated for the total population in 2013 and 2019 and according to sociodemographic variables for 2019. Poisson regression with robust variance was used to assess differences in prevalence. RESULTS There was an improvement in most of the indicators studied: an increase in ex-smokers, a reduction in secondhand smoke and attempts to quit smoking. All pro- and anti-tobacco media exposure indicators declined. When considering the prevalence according to sociodemographic characteristics in 2019, 43.8% (95%CI 41.6-46.0) of men tried to quit smoking, and 50.8% (95%CI 48.5-53.2) of women. Secondhand smoke at home was higher among women (10.2%; 95%CI 9.7-10.8). Among those who thought about quitting smoking because of warnings, the proportion was higher among women (48.0%; 95%CI 45.3-50.6). Tobacco use was higher among men (43.8%; 95%CI 41.6-46.0), in the population aged 40 to 59 years (14.9%; 95%CI 14.2-15.6), with a lower level of education (17.6%; 95%CI 16.8-18.4). CONCLUSION The study showed improvement in tobacco-related indicators between the years studied. It is noteworthy that this advance was smaller in relation to the other periods previously analyzed, and therefore, greater investments in public policies to combat and control smoking in Brazil are necessary.
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Affiliation(s)
- Deborah Carvalho Malta
- Departament of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Crizian Saar Gomes
- Post-graduation Program Public Health, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | - Fabiana Martins Dias de Andrade
- Departament of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Elton Junio Sady Prates
- Departament of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Francielle Thalita Almeida Alves
- Departament of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | | | | | - Cimar Azeredo Pereira
- Diretorate of Research, Instituto Brasileiro de Geografia e Estatística - Rio de Janeiro (RJ), Brazil
| | - Roberta de Betânia Caixeta
- Pan-American Health Organization/World Health Organization for the Americas - Washington DC, United States
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23
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B. Leme AC, Ferrari G, Fisberg RM, Kovalskys I, Gómez G, Cortes LY, Yépez Gárcia MC, Herrera-Cuenca M, Rigotti A, Liria-Domínguez MR, Fisberg M. Co-Occurrence and Clustering of Sedentary Behaviors, Diet, Sugar-Sweetened Beverages, and Alcohol Intake among Adolescents and Adults: The Latin American Nutrition and Health Study (ELANS). Nutrients 2021; 13:nu13061809. [PMID: 34073533 PMCID: PMC8228398 DOI: 10.3390/nu13061809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 12/12/2022] Open
Abstract
Poor diet, sedentary behaviors, sugar-sweetened beverages (SSB) and alcohol intake seem to co-exist in complex ways that are not well understood. The aim of this study was to provide an understanding of the extent to which unhealthy behaviors cluster in eight Latin America countries. A secondary aim was to identify socio-demographic characteristics associated with these behaviors by country. Data from adolescents and adults from the “Latin American Health and Nutrition Study” was used and the prevalence of screen-time, occupational and transportation–sedentary time, socializing with friends, poor diet, SSB and alcohol intake, alone and in combination, were identified. The eight Latin America (LA) countries added to analyses were: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela. Logistic regression was used to estimate associations between ≥2 behaviors clustering, socio-demographics and weight status. Among 9218 individuals, the most prevalent behaviors were transportation and occupation–sedentary time, SSB and alcohol intake. Younger, female, married/living with a partner, low and middle-income and obese individuals had higher chances for these clustering behaviors. These results provide a multi-country level of understanding of the extent to which behaviors co-occur in the LA population.
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Affiliation(s)
- Ana Carolina B. Leme
- Center for Excellence in Nutrition and Feeding Difficulties, PENSI Institute, Sabará Children’s Hospital, São Paulo 05076-040, Brazil;
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada
- Correspondence:
| | - Gerson Ferrari
- Escuela de Ciências de la Actividad Fisica, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 7500618, Chile;
| | - Regina M. Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 05508-060, Brazil;
| | - Irina Kovalskys
- Faculty of Medicine, Pontifical Catholic University from Argentina, Buenos Aires C1107AAZ, Argentina;
| | - Georgina Gómez
- Department of Biochemistry, School of Medicine, University of Costa Rica, San José 11501-2060, Costa Rica;
| | - Lilia Yadira Cortes
- Department of Nutrition and Biochemistry, Pontifical University Catholic from Javeriana, Bogota 111321, Colombia;
| | | | - Marianella Herrera-Cuenca
- Center of Developmental Studies, Central University of Venezuela (CENDES-UCV)/Bengoa Foundation, Caracas 47604, Venezuela;
| | - Attilo Rigotti
- Center of Molecular Nutrition and Chronic Diseases, Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontifical Catholic University from Chile, Santiago 833115, Chile;
| | - María Reyna Liria-Domínguez
- Investigacíon Nutricional, La Molina, Lima 15024, Peru;
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciências Aplicadas, Lima 15023, Peru
| | - Mauro Fisberg
- Center for Excellence in Nutrition and Feeding Difficulties, PENSI Institute, Sabará Children’s Hospital, São Paulo 05076-040, Brazil;
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24
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Malta DC, Gomes CS, Barros MBDA, Lima MG, Almeida WDSD, Sá ACMGND, Prates EJS, Machado ÍE, Silva DRPD, Werneck ADO, Damacena GN, Souza Júnior PRBD, Azevedo LOD, Montilla DER, Szwarcwald CL. Noncommunicable diseases and changes in lifestyles during the COVID-19 pandemic in Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210009. [PMID: 33950138 DOI: 10.1590/1980-549720210009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/14/2020] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To compare lifestyle changes during the COVID-19 pandemic according to the presence or absence of noncommunicable diseases (NCDs) in Brazilian adults. METHODS Cross-sectional study, using data from the ConVid survey, between April and May 2020. The following variables were evaluated: lifestyle and presence of one or more NCDs (diabetes, hypertension, respiratory disease, heart disease, and cancer). Sociodemographic characteristics were used as adjustment. Relative frequencies and confidence intervals (CI) of 95% of the explanatory variables were calculated before and during the pandemic. For the comparison of groups, with or without NCDs, crude and adjusted (PRadj) prevalence ratios were estimated by Poisson regression. RESULTS There was a reduction in physical activity (60% in those without NCDs and 58% in those with NCDs) and in vegetable consumption (10.8% in those without NCDs and 12.7% in those with NCDs). On the other hand, there was an increase in the time spent watching television and on screens of computer/tablet (302% and 43.5% in those without NCDs and 196.5% and 30.6% with NCDs, respectively); consumption of frozen meals (43.6% in those without NCDs and 53.7% with NCDs), snacks (42.3% without NCDs and 31.2% with NCDs), and chocolate (14.8% without NCDs). During the pandemic, patients with NCDs were less active (PRadj = 0.77; 95%CI 0.65 - 0.92), had greater habit of watching TV (PRadj = 1.16; 95%CI 1.08 - 1.26), and consumed less vegetables (PRadj = 0.88; 95%CI 0.81 - 0.96). CONCLUSION It was evident that adults with NCDs had their lifestyles more altered during the COVID-19 pandemic.
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Affiliation(s)
- Deborah Carvalho Malta
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | - Crizian Saar Gomes
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | | | - Margareth Guimarães Lima
- Departamento de Saúde Coletiva, Faculdade de Ciências Médicas, Universidade Estadual de Campinas - Campinas (SP), Brasil
| | - Wanessa da Silva de Almeida
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brasil
| | | | | | - Ísis Eloah Machado
- Departamento de Medicina de Família, Saúde Mental e Coletiva, Escola de Medicina, Universidade Federal de Ouro Preto - Ouro Preto (MG), Brasil
| | | | - André de Oliveira Werneck
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Giseli Nogueira Damacena
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brasil
| | | | - Luiz Otávio de Azevedo
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brasil
| | - Dalia Elena Romero Montilla
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brasil
| | - Célia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz - Rio de Janeiro (RJ), Brasil
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25
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Cardoso LSDM, Teixeira RA, Ribeiro ALP, Malta DC. Premature mortality due to non-communicable diseases in Brazilian municipalities estimated for the three-year periods of 2010 to 2012 and 2015 to 2017. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210005. [PMID: 33886878 DOI: 10.1590/1980-549720210005.supl.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/12/2020] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To estimate premature mortality due to noncommunicable diseases (NCDs) in Brazilian municipalities. METHODS This ecological study estimated premature mortality rates due to cardiovascular diseases, chronic respiratory diseases, cancer and diabetes in Brazilian municipalities, for the three-year periods of 2010 to 2012 and 2015 to 2017, and it analyzed the spatial and temporal distribution of these rates. Data treatment combined proportional redistribution of the missing data and ill-defined causes, and the application of coefficients for under-registration correction. The local empirical Bayesian estimator was used to calculate municipal mortality rates. RESULTS Rates for the set of chronic diseases decreased in Brazil between the three-year periods. The mean rates for total NCDs declined in the South, Southeast and Central-West regions, remained stable in the North and increased in the Northeast. Mortality rates due to cardiovascular diseases were the highest in all regions but showed the greatest declines between the periods. Cancers were the second leading cause of death. The North and Northeast regions stood out as having increased mean rates of cancer between the periods analyzed and showing the highest mean premature mortality rates due to diabetes in the 2015 to 2017 period. CONCLUSION Spatial and temporal distribution of premature mortality rates due to NCDs differed between Brazilian municipalities and regions in the three-year periods evaluated. The South and Southeast had decreased rates of deaths due to cardiovascular and chronic respiratory diseases, as well as diabetes. The North and Northeast had increased rates of deaths due to cancer. There was an increase in the rate of deaths due to diabetes in the Central-West.
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Affiliation(s)
| | - Renato Azeredo Teixeira
- Post-Graduation Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil.,Research Group in Epidemiology and Health Evaluation, School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Antonio Luiz Pinho Ribeiro
- Hospital das Clínicas and School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Deborah Carvalho Malta
- Department of Maternal-Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil
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Food marketing in supermarket circulars in Brazil: An obstacle to healthy eating. Prev Med Rep 2021; 21:101304. [PMID: 33643813 PMCID: PMC7887421 DOI: 10.1016/j.pmedr.2020.101304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/25/2020] [Accepted: 12/01/2020] [Indexed: 11/21/2022] Open
Abstract
The study aims to characterize the foods advertised in supermarket circulars in Belo Horizonte, Brazil, as well as to analyze the price and discounts applied to the products. Supermarket circulars were obtained from five supermarket chains during 2018. Foods were classified according to the NOVA classification system and the Pan-American Health Organization (PAHO) nutritional profile model. Advertised prices, with and without discount, were recorded. Ultra-processed foods responded for 66.9% of ads, followed by fresh or minimally processed foods with 19.9%, processed foods with 9.5%, and processed culinary ingredients with 3.7%. Only 3.5% of the products did not exceed any critical nutrients of the PAHO model. Processed foods had a higher cost (R$3.27/100 g) in relation to other food categories. Products excessive in trans-fat and sodium were statistically significant cheaper when compared to those that did not present inadequacy of these nutrients. The reverse was verified for foods excessive in saturated fat, in total fat and in added sugars. Processed culinary ingredients were more frequent on sale (27.7%), while processed foods were the least advertised with discount (15.9%). Products that were adequate in saturated fat, trans fat, total fat and added sugar were statistically significant more announced with discount. Processed culinary ingredients presented the lowest percentage of discount (13.5%). The study confirms the position of supermarket circulars in Brazil as an obstacle to healthy eating, due to the higher incidence of processed and ultra-processed food advertisements, although no greater financial stimulus was noted for these products.
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