Factors affecting Brazilians' self-rated health during the COVID-19 pandemic

Associations Between Healthy Behaviors and Persistently Favorable Self-Rated Health in a Longitudinal Population-Based Study in Switzerland

BACKGROUND

Self-rated health is a subjective yet valuable indicator of overall health status, influenced by various factors including physical, psychological, and socio-economic elements. Self-rated health could be telling and used by primary care physicians to evaluate overall present and predictive health.

DESIGN

This study investigates the longitudinal evolution of self-rated health in Switzerland during the COVID-19 pandemic, focusing on the association of persistently favorable self-rated health with various predictors.

PARTICIPANTS

This study based on the Specchio cohort, a population-based digital study in Geneva Switzerland, involved participants completing questionnaires from 2021 to 2023.

MAIN MEASURES

Self-rated health was assessed alongside factors like physical and mental health, socio-economic status, and lifestyle behaviors.

KEY RESULTS

The study included 7006 participants in 2021, and 3888 participants who answered all three follow-ups (2021, 2022, and 2023). At baseline, 34.9% of individuals reported very good, 54.6% reported good, 9.6% reported average, and 1.0% reported poor to very poor self-rated health. Overall, 29.1% had a worsening in their self-rated health between 2021 and 2023. A subset of participants (12.1%) maintained very good self-rated health throughout, demonstrating persistently favorable self-rated health during the COVID-19 pandemic. Positive health behaviors were associated with persistently favorable self-rated health (exercise aOR 1.13 [1.03-1.24]; healthy diet aOR 2.14 [1.70-2.68]; less screen time aOR 1.28 [1.03-1.58]; and better sleep quality aOR 2.48 [2.02-3.04]). Mental health and social support also played significant roles.

CONCLUSION

The study underscores the significance of healthy lifestyle choices and social support in maintaining favorable self-rated health, particularly during challenging times like the COVID-19 pandemic. Primary care physicians should focus on promoting these factors, integrating these actions in their routine consultations, and advising patients to undertake in socially engaging activities to improve overall health perceptions and outcomes.

Self-Rated Health and its Impact on Survival of Older Adults

Background

Self -rated health (SRH) is a subjective assessment of health status that results from asking a question as "How do you assess your health?". The aim of this study was to determine the value of SRH for survival of older adults.

Materials and Methods

This cohort study was conducted among a population aged 60 years and over living in the north region of Iran. The participants' characteristics including demographic information, life-style behaviors, medical history, body mass index, depressive symptoms, cognitive function, and social support were examined. SRH was categorized into two groups (1. poor or fair and 2. good or excellent). All of the study population were followed up again after 5 years to determine the survival condition.

Results

Totally, 1475 elderly people were included. Good or excellent SRH showed a significant association with male gender, to be married, higher physical activity, less co-morbid chronic disorders, no depressive symptoms, normal cognitive function, higher social support, smoking (P < 0.001), and normal body mass index (BMI) (P = 0.021); however, no significant association with age (P < 0.083) was observed. Out of 944 elderly people expressing good or excellent SRH, 85 (9%) persons died after 5-year follow-up (P < 0.001). Cox regression analysis revealed that SRH had a significant impact on mortality of older adults (adjusted hazard ratio = 1.447; 95% confidence interval: 1.008-2.076; P = 0.045).

Conclusion

Considering health-related characteristics including age, gender, number of drugs the participant was taking, physical activity, BMI, and social support, SRH showed a significant effect on 5-year survival of older adults.

Self-rated health and sociodemographic inequalities among Venezuelan adults: a study based on the National Survey of Living Conditions (ENCOVI 2021)

Self-rated health is an indicator that can be easily identified in health surveys, widely used to measure physical, social, mental, and health aspects of the population, and predict premature mortality. In Venezuela, this information only began to be collected recently, in the National Survey of Living Conditions (ENCOVI). In this context, our study aims to analyze the demographic and socioeconomic factors associated with non-positive self-rated health among Venezuelan adults. The ENCOVI 2021 (n = 16,803) was used as a data source, assessing a probability stratified sample with questions about health, education, emigration, and other social and economic aspects. Crude and adjusted prevalence ratio analyses were performed using Poisson regression models with robust variance. The prevalence of fair/bad self-rated health among Venezuelans was 17.8%. The results indicated a strong association between outcome prevalence and age group, 3.81 times higher (95%CI: 3.29-4.41) among individuals aged 60 or more when compared to individuals aged 18 to 29 years. Also, participants experiencing severe food insecurity had a prevalence 2 times higher (95%CI: 1.61-2.47) than those who did not have any level of food insecurity. Factors such as poverty, education, recent emigration of family members, and sex also showed a significant influence, also when analyzed independently. The results show that special attention should be dedicated to the health of individuals facing hunger and of the older people.

Factors associated with worsening in the self-rated health status of Brazilian women who lived with dependent elderly people during the first wave of COVID-19

The objective is to analyze the factors associated with the worsening of the self-rated health (SRH) of Brazilian women who live with elderly people with functional dependence (EFD) during the first wave of COVID-19. ConVid - Behavior Research was used as a data source. For the analysis, the group of women who lived with EFD was compared with those who lived with the elderly without any dependence. Hierarchical prevalence ratio (PR) models were estimated to test the associations between sociodemographic characteristics, changes in income, routine activities and health in the pandemic, with the outcome of worsening SRH. This worsening was more frequent in the group of women living with EFD. After adjusting for hierarchical factors, being black (PR=0.76; 95%CI 0.60-0.96) and having a per capita income lower than minimum wage (PR=0.78; 95%CI 0.64- 0.96) were shown to be protective factors for SRH worsening among EFD co-residents. Indisposition, emergence/worsening of back problems, affected sleep, poor SRH, feeling loneliness and difficulty in carrying out routine activities during the pandemic were positively associated factors. The study demonstrates that living with EFD was associated with a worsening in the health status of Brazilian women during the pandemic, especially among those of higher social status.

Uncertainty stress and self-rated health during the early stage of the COVID-19 outbreak

Objectives

The COVID-19 crisis caused unparalleled uncertainty stress and health-related symptoms among Chinese residents. This study aimed to characterize stress status during the early stage of the pandemic and explore the inner mechanism between uncertainty stress and self-rated health.

Setting/participants

A cross-sectional design was conducted online from February 7 to 14, 2020. A total of 2534 Chinese participants were surveyed.

Main outcome measures

Uncertainty stress, negative affect, sleep quality, and health status were measured by self-report. A sequential mediation model using bootstrapping method was applied to test these relationships.

Results

Age, place of residence, marital status, occupation, household annual income, infection, and quarantine status significantly correlated with uncertainty stress. Higher uncertainty stress was negatively related with self-rated health (r = -0.256, p < 0.01) and positively associated with higher negative emotions (r = 0.646, p < 0.01). The sequential mediation model found total indirect effect (β = -0.014, 95%C.I. = -0.017-0.010) and direct effect (β = -0.010, 95%C.I. = -0.015-0.005) were significant in the relationship between uncertainty stress and self-rated health with mediating by negative affect and subjective sleep quality.

Conclusions

Findings provided evidence-based information for stakeholders designing and implementing intervention strategies by providing psychological consultation services and public education to manage uncertainty stress and minimize the damage of negative affect and poor sleep.

Nutritional changes during the COVID-19 pandemic: a rapid scoping review on the impact of psychological factors

COVID-19 and the resulting measures to curb the spread of the virus have significantly changed our lives, including our nutritional choices. In this rapid scoping review an overview is provided of what psychological factors may be associated with peoples' eating behaviour during COVID-19 restrictions. Relevant literature was identified using PubMed, PsycInfo, CINAHL and MEDLINE databases from 2019 onwards. For included studies, information on study characteristics, eating behaviours, and psychological factors were extracted. 118 articles were included, representing 30 countries. Findings indicated that most people consumed more and unhealthy food in times of COVID-19 restrictions, while some consumed less but often for the wrong reasons. Several psychological factors, related to (1) affective reactions, (2) anxiety, fear and worriers, (3) stress and (4) subjective and mental wellbeing were found to be associated with this increase in food consumption. These outcomes may help to be better inform future interventions, and with that, to be better prepared in case of future lockdown scenarios.

Daily Habits of Brazilians at Different Moments of the COVID-19 Pandemic

BACKGROUND

The COVID 19 pandemic impacted the health and well-being of different populations around the world. The aim of this study is to investigate the changes in the daily habits of Brazilians before and during two moments of the COVID-19 pandemic.

METHODS

A longitudinal study in which an online questionnaire (sleeping time, alcohol consumption, smoking, use of screen devices, physical activity, and dietary patterns) was applied at three moments.

RESULTS

The frequency of alcohol consumption, smoking, and sleep hours did not change significantly at different times. For the number of alcoholic beverages, there was a reduction in consumption from T0 to T1 and an increase from T1 to T2. There was a significant increase in hours of screen device use from T0 to T1, remaining high at T2. Finally, the level of physical activity in minutes reduced from T0 to T1, returning to base levels at T2. As for eating habits, there was an increase in the frequency of consumption of instant meals, fast food, and sweets at the first moment, with a significant reduction at the second moment. The consumption of legumes, milk and dairy products, bakery products, and meats was higher at T2.

CONCLUSIONS

Some habits returned to or approached T0 levels. However, other habits remained unchanged, such as screen time and frequency of consumption of some food groups, throughout the last evaluation.

Self-rated health when population health is challenged by the COVID-19 pandemic; a longitudinal study

RATIONALE

The coronavirus disease 2019 (COVID-19) pandemic and consequent lockdown measures have had a large impact on people's lives. Recent evidence suggests that self-rated health (SRH) scores remained relatively stable or increased during the pandemic.

OBJECTIVE

For the current project, we examine potential changes in the variance decomposition of SRH before and during the COVID-19 pandemic in the Netherlands.

METHODS

We analyse data from the Netherlands Twin Register to examine pre-pandemic SRH scores (N = 16,127), pandemic SRH scores (N = 17,451), and SRH difference scores (N = 7464). Additionally, we perform bivariate genetic analyses to estimate genetic and environmental variance components in pre-pandemic and pandemic SRH, and estimate the genetic correlation to assess potential gene-environment interaction.

RESULTS

The majority of the sample (66.7%) reported the same SRH before and during the pandemic, while 10.8% reported a decrease, and 22.5% an increase. Individuals who reported good/excellent SRH before the pandemic were most likely to report unchanged SRH during the pandemic, and individuals with bad/mediocre/reasonable SRH more often reported increased SRH. The bivariate longitudinal genetic model reveals no significant change in variance decomposition of SRH from before to during the pandemic, with a heritability estimate of 45% (CI 36%-52%). We found that the genetic correlation could be constrained to 1, and a moderate unique environmental correlation (r_E = 0.49, CI = 0.37 to 0.60).

CONCLUSIONS

We theorize that the increases in SRH are explained by uninfected individuals evaluating their health more positively than under normal circumstances (partly through social comparison with infected individuals), rather than actual improvements. As the same genes are expressed under different environmental exposures, these results imply no evidence for gene-environment interaction. While different environmental factors might influence SRH at the two time-points, the influence of environmental factors does not become relatively more important during the pandemic.

Digital Form for Assessing Dentists' Knowledge about Oral Care of People Living with HIV

Oral lesions are usually the first sign of HIV infection. The present study aimed to determine the level of the knowledge of dentists on the dental care needs of People Living with HIV (PLWH). This cross-sectional study was conducted between February and May 2021, in the Brazilian state of Pará, during which a total of 51 dentists received an anonymous digital form (Google^® Forms Platform) composed of four blocks of discursive, dichotomous, and multiple-choice questions. The questions referred to various aspects of the dental care needs of PLWH, together with data on the professional activities of the dentists. After signing the term of informed consent, the dentists were divided into six subgroups according to the time (in years) since completing their bachelor’s degree in dentistry. The data were presented as descriptive statistics and percentages, and then analyzed using the Kappa test. Most (70.6%; 36 of 51) of the dentists were female, the mean age of the dentists was 32.5 years, and a majority (80.2%) were based in the city of Belem; the mean time since graduation was 8.5 years, with 22 (43.1%) having more than 5 years of professional experience, and 31 (60.8%) having graduated from a private dental college. Just over half (51%) of the 51 dentists had completed graduate courses, and the most common dental specialty was orthodontics (19.6%). Most (74.5%) of the dentists work in the private sector, 38 (74.5%) claimed to have already provided oral care to PLWH, and 43 (84.3%) had access to specialist content on the oral care needs of PLWH. In terms of the knowledge of the dentists with regard to the oral care needs of PLWH, four of the ten diagnostic questions obtained more inadequate answers than expected, whereas the final two questions (11–45.1% and 12–31.4%) demonstrated that many of the dentists adopt unnecessary modifications in their oral care protocol for PLWH, due to a fear of contamination. Overall, our results demonstrate a frequent lack of knowledge, especially with regard to the oral healthcare needs of PLWH, which may account for many of the stigmas that persist in the dental care of this vulnerable group.

Autoavaliação ruim do estado de saúde: prevalência e fatores associados em mulheres privadas de liberdade

Resumo Objetivo Verificar a prevalência da autoavaliação ruim do estado de saúde em mulheres encarceradas e analisar os fatores associados. Método Trata-se de estudo transversal, realizado entre os anos de 2019 e 2020, por meio de censo, com participação de 99 mulheres. A análise dos fatores associados ao desfecho foi conduzida a partir de um modelo teórico de determinação com três blocos hierarquizados de variáveis. As variáveis foram ajustadas entre si dentro de cada bloco. Aquelas com nível de significância ≤ 0,20 foram incluídas no modelo de regressão de Poisson e ajustadas ao nível superior ao seu, considerando o nível de 5% de significância. Resultados A prevalência da autoavaliação ruim da saúde foi de 31,3% (IC95% = 22,8%–40,9%). Morbidade referida, presença de sintomas de ansiedade e a pior perspectiva em relação às condições de saúde pós-encarceramento foram as variáveis associadas com o desfecho. Considerações finais e implicações para a prática Os fatores associados à ocorrência do evento investigado poderão direcionar medidas que visem à redução dos impactos à saúde durante o período de encarceramento.

Determinants of poor sleep quality in adults during the coronavirus disease pandemic: COVID-Inconfidentes, a population-based study

BACKGROUND

The coronavirus disease (COVID-19) pandemic has adversely affected the health of the global population, with sleep quality being one of the affected parameters.

OBJECTIVES

To evaluate sleep quality and its associated factors in adults during the COVID-19 pandemic in Brazil.

DESIGN AND SETTING

A population-based cross-sectional serological survey of 1,762 adults in the Iron Quadrangle region of Brazil.

METHODS

The Pittsburgh Sleep Quality Index was used to assess sleep quality. Sociodemographic variables, health conditions, health-related behaviors, anxiety, vitamin D levels, weight gain/loss, and pandemic characteristics were assessed using a structured questionnaire. Univariate and multivariate analyses using Poisson regression with robust variance were performed to identify factors associated with sleep quality.

RESULTS

More than half of the participants reported poor sleep quality (52.5%). Multivariate analysis revealed that the factors associated with poor sleep quality included living alone (prevalence ratio [PR] = 1.34; 95% confidence interval [CI]: 1.04-1.73), anxiety disorder (PR = 1.32; 95% CI: 1.08-1.62), 5.0% weight loss (PR = 1.21; 95% CI: 1.02-1.44), 5.0% weight gain (PR = 1.27; 95% CI: 1.03-1.55), vitamin D deficiency (PR = 1.16; 95% CI: 1.01-1.35), and COVID-19 symptoms (PR = 1.29; 95% CI: 1.10-1.52).

CONCLUSIONS

Our study revealed that more than half of the participants experienced poor sleep quality during the COVID-19 pandemic. Factors associated with poor sleep quality included vitamin D deficiency and weight changes related to the pandemic.

Back pain occurred due to changes in routinary activities among Brazilian schoolteachers during the COVID-19 pandemic

Objective

This study’s main objective was to investigate the emergence of back pain as a consequence to changes in usual activities due to the COVID-19 pandemic among teachers in public schools in the state of Minas Gerais, Brazil.

Methods

A cross-sectional study was conducted among 15,276 schoolteachers using an online questionnaire. The variables included sociodemographic and occupational data, health situation, habits and behaviors during the COVID-19 pandemic. Bivariate analyses using Pearson’s chi-square test and multiple analyses using Poisson regression were performed to identify the associated factors.

Results

About 58% of schoolteachers reported back pain due to changes in routine activities during the pandemic. The adjusted model showed a correlation between back pain and female sex, longer working hours, overwork, difficulties concerning distance working, negative changes in health status and quality of sleep; frequent feeling of sadness, depression, or anxiety; use of medications to relax, sleep or against stress/anxiety/depression; physical inactivity or negative changes in the practice of physical activities; increased body weight; reduction of leisure time; increased time of use of computer or tablet and overload of housework.

Conclusion

During the COVID-19 pandemic, schoolteachers reported a high prevalence of emergence of back pain, which delineates a contradiction in terms: on the one hand, distance education allows social distancing that contributes to the preservation of teachers’ health by reducing the risk of contamination by COVID-19. On the other hand, it imposes new demands that—in disagreement with working conditions—can threaten the health of these workers.

Associations of Sociodemographic Factors and Health Behaviors with the Emotional Well-Being of Adolescents during the COVID-19 Pandemic in Brazil

This cross-sectional study utilizes data from a nationwide web-based survey aimed to identify the factors affecting the emotional well-being of Brazilian adolescents aged 12–17 during the period of school closures and confinement. Data collection took place from 27 June to 17 September 2020. We used the “virtual snowball” sampling method, and students from private and public schools were included. A total of 9470 adolescents were analyzed. A hierarchical logistic regression model was used to find the factors associated with reporting at least two of three self-reported problems—sadness, irritability, and sleep problems. The main proximal factor was loneliness (AdjOR = 8.12 p < 0.001). Problems related to school closures also played an important role. Regular intake of fruits and vegetables, as well as physical activity, demonstrated a positive influence on emotional well-being, while excessive screen time (AdjOR = 2.05, p < 0.001) and alcohol consumption negatively affected outcomes (AdjOR = 1.73, p < 0.001). As for distal variables, less affluent adolescents were the most affected, and males reported fewer emotional problems than females. Uncertainty regarding the disease in a context of socioeconomic vulnerability, together with rises in unhealthy behaviors and isolation from their immediate social circles, have negatively affected adolescents’ emotional status throughout the COVID-19 pandemic.