Abstract
BackgroundConsidering the high socioeconomic inequalities in Brazil related to occurrence of morbidity and premature mortality, the objective of this study was to analyze inequalities in self-reported prevalence of Non-Communicable Diseases (NCD) and in the physical limitations caused by these diseases, among the Brazilian adult population, according to sociodemographic variables.MethodsThis was a population-based cross-sectional study that analyzed information on 60,202 individuals who formed a representative sample of Brazilian adults interviewed for the National Health Survey 2013. Disparities by schooling levels and possession of private health insurance were assessed by calculating the prevalence (P) and prevalence ratio (PR) of each of the 13 NCDs and any associated limitations, while controlling for other socioeconomic and demographic variables.Results45 % of the Brazilian adult population reported having at least one NCD. The prevalence ratio was greater among women (1.24 CI 1.21-1.28), individuals over 55 years of age, individuals with low schooling levels (illiterate and incomplete elementary education) (1.08 CI 1.02-1.14) and people living in the Southeast (1.10 CI 1.04-1.16), South (1.26 CI 1.19-1.34) and Central-West (1.11 CI 1.05-1.18) regions of the country. Diseases such as diabetes (1.42 CI 1.13-1.47), hypertension (1.17 CI 1.06-1.28), stroke (2.52 CI 1.74-3.66), arthritis (1.4 CI 1.11-1.77), spinal problems (1.39 CI .1.25-1.56), and chronic renal failure (1.65 CI 1.10.2.46), were more prevalent among adults with low education. For most NCDs, greater reports of limitations were associated with lower schooling levels and lack of private health insurance.ConclusionPopulations with lower schooling levels and lack of private health insurance present higher prevalence of various NCD and greater degrees of limitation due to these diseases. Results reveal the extent of social inequalities that persist with regard to occurrence and the impact of NCDs in Brazil.
Highlights
Considering the high socioeconomic inequalities in Brazil related to occurrence of morbidity and premature mortality, the objective of this study was to analyze inequalities in self-reported prevalence of Non-Communicable Diseases (NCD) and in the physical limitations caused by these diseases, among the Brazilian adult population, according to sociodemographic variables
The prevalence and prevalence ratios were higher among women (PR = 1.24 confidence intervals (CI) 1.21-1.28) and increased progressively with advancing age
In relation to the regions where the participants lived, higher morbidity was observed in the South (PR = 1.26 CI 1.19-1.34), Southeast (PR = 1.10 CI 1.04-1.16) and Center-West (PR = 1.11 CI 1.05-1.18) than in the North of Brazil (Table 1)
Summary
Considering the high socioeconomic inequalities in Brazil related to occurrence of morbidity and premature mortality, the objective of this study was to analyze inequalities in self-reported prevalence of Non-Communicable Diseases (NCD) and in the physical limitations caused by these diseases, among the Brazilian adult population, according to sociodemographic variables. The increased burden of NCDs reflects rapid population aging coupled with negative effects of rapid urbanization, sedentary living and diets with high calorie content, along with marketing of tobacco and alcohol [4]. This burden especially affects the poorer and more vulnerable segments of the population. A vicious circle is often created, in which family expenditures on NCDs is expanded, thereby reducing the availability of resources for necessities such as food, housing and education, among others This may lead to a greater state of poverty for these families [2, 3, 5], which worsens social inequalities [2, 3]
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