Non-communicable Diseases In Brazil Research Articles

Social inequalities in the prevalence of self-reported chronic non-communicable diseases in Brazil: national health survey 2013.

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.

Effectiveness of a scaled up physical activity intervention in Brazil: A natural experiment

Physical inactivity causes 5.3 million deaths annually worldwide. We evaluated the impact on population leisure-time physical activity (LTPA) of scaling up an intervention in Brazil, Academia das Cidades program (AC-P). AC-P is a health promotion program classified as physical activity classes in community settings which started in the state of Pernambuco state in 2008.We surveyed households from 80 cities of Pernambuco state in 2011, 2012 and 2013, using monitoring data to classify city-level exposure to AC-P. We targeted 2370 individuals in 2011; 3824 individuals in 2012; and 3835 individuals in 2013. We measured participation in AC-P and whether respondents had seen an AC-P activity or heard about AC-P. We measured LTPA using the International Physical Activity Questionnaire. We estimated the odds of reaching recommended LTPA by levels of exposure to the three AC-P measures.For women, the odds of reaching recommended LTPA were 1.10 for those living in cities with AC-P activity for less than three years, and 1.46 for those living in cities with AC-P activity for more than three years compared to those living in cities that had not adopted AC-P. The odds of reaching recommended LTPA increased with AC-P participation and knowledge about AC-P.AC-P exposure is associated with increased population LTPA. Extending AC-P to all cities could potentially impact non-communicable diseases in Brazil.

Method for projecting indicators for the goals of the Strategic Action Plan for Tackling Chronic Non-Communicable Diseases in Brazil according to Capitals and the Federal District

to present the indicators' projection method of the Strategic Action Plan for Tackling Chronic Non-Communicable Diseases (NCDs) in Brazilian State capitals and the Federal District, 2012-2022. simple linear regression model was used to calculate the indicators' projections with data from the Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel). in most of the capitals, there was an increase in the prevalence of obesity (annual change: 0.36%;1.29%), overweight (annual change: 1.11%;2.00%), recommended (annual change: 1.45%;2.66%) and regular (annual change: 0.45%;1.46%) consumption of fruits and vegetables; smoking presented a decreasing trend (annual change: -1.34%;-0.20%); whereas physical inactivity, heavy drinking and mammography and Pap smears examinations were stable. most of the goals are possible; however, effective actions are necessary, especially for tackling overweight and heavy drinking.

Progress with the Strategic Action Plan for Tackling Chronic Non-Communicable Diseases in Brazil, 2011-2015.

to describe the actions undertaken by the Strategic Action Plan for Tackling Chronic Non-Communicable Diseases (NCDs) in Brazil, from 2011 to 2015. the actions were identified through sectorial and interministerial meetings, annual forums, as well as document reviews of publications and laws on government websites. the actions found were: national surveys and monitoring of mortality and risk factor reduction targets; encouragement of physical activity, adequate nutrition and health promotion through the creation of the Health Gym Program (Programa Academia da Saúde); the publication of legislation on tobacco-free environments; free of charge drugs for hypertension, diabetes, and asthma; organization of the emergency service network for cardiovascular diseases; and expanding access to diagnosis and treatment of cancer patients. we found progress regarding surveillance, health promotion and comprehensive care; in general, the goals of the Plan are being met.

Access to medicines for chronic diseases in Brazil: a multidimensional approach.

ABSTRACTOBJECTIVE To analyze the access to medicines to treat non-communicable diseases in Brazil according to socioeconomic, demographic, and health-related factors, from a multidimensional perspective.METHODS Analysis of data from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM), household survey, sampling plan by conglomerates with representativeness of the Brazilian population and large areas of the country, according to sex and age domains. Data collected in 2013–2014 with sample of adults (≥ 20 years) who reported having non-communicable diseases and medical indication for use of medicines (n = 12,725). We assessed the prevalence of access to medicines for self-reported non-communicable diseases, considering four dimensions: availability, geographic accessibility, acceptability, and affordability. We applied Pearson’s Chi-square test to assess the statistical significance of the differences between strata, considering the level of significance of 5%. We found prevalence of 94.3%, 5.2%, and 0.5% for full, partial, and null access, respectively. Higher prevalence was observed among seniors in the South compared to the Northeast; for those who reported having one non-communicable disease compared to those who reported having two or more; for those who needed one medicine compared to those who needed three or more; and for those who self-assessed their health as good or very good. Geographic accessibility was similar in the Unified Health System and in the private pharmacies (72.0%). Total availability of medicines was 45.2% in the Unified Health System, 67.4% in the Popular Pharmacy Program, and 88.5% in private pharmacies. Acceptability was 92.5% in the Unified Health System, 97.8% in the Popular Pharmacy Program, and 98.7% in private pharmacies. As to affordability, 2.6% of the individuals failed to take the medicines they should in the 30-day period prior to the interview due to financial difficulty. Prevalence of full access to medicines for non-communicable diseases in Brazil is high and presents significant differences for age group, region of the country, number of non-communicable diseases, and for medicines prescribed and self-assessment of health. The major barriers to access to medicines were identified in the dimensions analyzed.

Trends in premature mortality due to chronic non-communicable diseases in Brazilian federal units.

Chronic non-communicable diseases (NCDs) have a high mortality rate, mainly in lower and middle income countries. The major groups are cardiovascular disease (CVD), chronic respiratory disease (CRD), cancer and diabetes. The Action Plan to reduce NCDs in Brazil, 2011-2022 established a 2% yearly reduction in the NCD premature mortality rate as a goal. The aim of the study was to analyze trends in premature mortality rates and also show goal achievement scenarios for each Federal Unit (FU). A time series analysis of the standardized mortality rate between 2000-2011 was performed using the linear regression model. The average annual rate of increase and the 95% confidence interval were estimated. Each FU was classified as being likely or unlikely to achieve the goal. The FUs likely to achieve the goal were: for CVD - Federal District, Santa Catarina, Mato Grosso, Rio Grande do Sul, Minas Gerais, Bahia, Espírito Santo and Paraná states; for CRD - Amazonas, Federal District and Paraná. For neoplasms and diabetes, none of the FUs are likely to achieve the goal. The articulation of the three levels of government will allow the strengthening of interventions to reduce the determinants of NCDs and to improve access and quality in health care.

Impact Of Physical Inactivity On Hospitalizations And Costs Resulting From Major Non-communicable Diseases In Brazil

Impact Of Physical Inactivity On Hospitalizations And Costs Resulting From Major Non-communicable Diseases In Brazil

Behavioural patterns of protective and risk factors for non-communicable diseases in Brazil.

To identify behavioural patterns of protective and risk factors for non-communicable diseases (NCD) and to explore the association between these patterns and sociodemographic characteristics. Principal component analysis was used to identify behavioural patterns from a list of twelve protective and risk factors for NCD. Linear regression was used to explore the association between the patterns and sociodemographic characteristics. Participants from the Brazilian Surveillance System of Risk and Protective Factors for NCD through Telephone Interviews (VIGITEL) from the years 2009 and 2010 were included. A sample of 108 706 adults was included in the analysis. Two behavioural patterns were identified in the analysis, a 'prudent pattern' and a 'risky pattern'. The first involved mostly protective behaviours, while the second one involved essentially the risky ones. Both the less prudent and the more risky behaviour patterns were concentrated in younger men, with lower education, from the more developed region. Public policies to decrease NCD should be aware of the possible tendency towards behavioural patterns in order to be more effective.

OP21 An Economic Evaluation of Non-Communicable Diseases in Brazil

BackgroundNon-communicable diseases are increasingly recognised as the major health issue facing many governments. Brazil has observed a rapid change in the weight profiles of its population, with the prevalence of...

Policies to promote physical activity in Brazil

Non-communicable diseases (NCDs) are the leading cause of mortality in Brazil and accounted for 72% of all deaths in 2007.1 The burden of NCDs in Brazil reflects accelerated epidemiological, demographic, and nutritional changes in the past few decades. In 1930, 46% of all deaths in Brazilian state capitals were caused by infectious diseases, but by 2007 this figure had fallen to 10%.1 During the same period, mortality from cardiovascular diseases increased from 11% to 31%.1–3 The country's demographic transition is the result of declines in premature mortality and fertility rates, alongside a rapidly ageing population.

Research on chronic noncommunicable diseases in Brazil: meeting the challenges of epidemiologic transition

In Brazil, chronic noncommunicable diseases (CNCDs) are the leading cause of death and a major contributor to the national disease burden. This article describes CNCD research funded by the Ministry of Health Department of Science and Technology (DECIT) to support the production and dissemination of scientific evidence for the national health system, in accordance with the National Agenda of Priorities in Health Research, and within the context of Brazil's epidemiologic transition. Data were obtained from Ministry of Health database management systems. CNCD-related projects financed by DECIT from 2002 to 2009 were analyzed by research theme (cancer, obesity, hypertension, diabetes, cardiovascular diseases, CNCDs in general, and CNCD risk factors) and geographic region. In terms of funding and number of projects, the most-supported research theme was cancer, and the most-supported region was the Southeast. Project type varied widely, ranging from basic scientific studies to highly technological research and development. Results obtained included epidemiologic profiles and surveillance, cost, and quality-of-life data.

Brazil: towards sustainability and equity in health

With a new government in place since January and a woman, Dilma Rousseff, at the helm, together with an economic growth rate of 7·5% last year and a newly discovered oil field off its coast, Brazil is a country in demand as a political and economic partner. Brazil now has an important and timely opportunity to cement its formidable health achievements towards its ultimate goal of universal, equitable, and sustainable health care to fulfil the right to health enshrined in its 1988 constitution. To highlight this opportunity, The Lancet is publishing a Series of six papers that critically examine what the country's policies have achieved and where future challenges might lie. The Brazilian health system: history, advances, and challengesBrazil is a country of continental dimensions with widespread regional and social inequalities. In this report, we examine the historical development and components of the Brazilian health system, focusing on the reform process during the past 40 years, including the creation of the Unified Health System. A defining characteristic of the contemporary health sector reform in Brazil is that it was driven by civil society rather than by governments, political parties, or international organisations. Full-Text PDF Maternal and child health in Brazil: progress and challengesIn the past three decades, Brazil has undergone rapid changes in major social determinants of health and in the organisation of health services. In this report, we examine how these changes have affected indicators of maternal health, child health, and child nutrition. We use data from vital statistics, population censuses, demographic and health surveys, and published reports. In the past three decades, infant mortality rates have reduced substantially, decreasing by 5·5% a year in the 1980s and 1990s, and by 4·4% a year since 2000 to reach 20 deaths per 1000 livebirths in 2008. Full-Text PDF Successes and failures in the control of infectious diseases in Brazil: social and environmental context, policies, interventions, and research needsDespite pronounced reductions in the number of deaths due to infectious diseases over the past six decades, infectious diseases are still a public health problem in Brazil. In this report, we discuss the major successes and failures in the control of infectious diseases in Brazil, and identify research needs and policies to further improve control or interrupt transmission. Control of diseases such as cholera, Chagas disease, and those preventable by vaccination has been successful through efficient public policies and concerted efforts from different levels of government and civil society. Full-Text PDF Chronic non-communicable diseases in Brazil: burden and current challengesNon-communicable diseases (NCDs) have become a major health priority in Brazil—72% of all deaths were attributable to NCDs in 2007. They are also the main source of disease burden, with neuropsychiatric disorders being the single largest contributor. Morbidity and mortality due to NCDs are greatest in the poor population. Although the crude NCD mortality increased 5% between 1996 and 2007, age-standardised mortality declined by 20%. Declines were primarily for cardiovascular and chronic respiratory diseases, in association with the successful implementation of health policies that lead to decreases in smoking and the expansion of access to primary health care. Full-Text PDF Violence and injuries in Brazil: the effect, progress made, and challenges aheadAlthough there are signs of decline, homicides and traffic-related injuries and deaths in Brazil account for almost two-thirds of all deaths from external causes. In 2007, the homicide rate was 26·8 per 100 000 people and traffic-related mortality was 23·5 per 100 000. Domestic violence might not lead to as many deaths, but its share of violence-related morbidity is large. These are important public health problems that lead to enormous individual and collective costs. Young, black, and poor men are the main victims and perpetrators of community violence, whereas poor black women and children are the main victims of domestic violence. Full-Text PDF Health conditions and health-policy innovations in Brazil: the way forwardBrazil is a large complex country that is undergoing rapid economic, social, and environmental change. In this Series of six articles, we have reported important improvements in health status and life expectancy, which can be ascribed largely to progress in social determinants of health and to implementation of a comprehensive national health system with strong social participation. Many challenges remain, however. Socioeconomic and regional disparities are still unacceptably large, reflecting the fact that much progress is still needed to improve basic living conditions for a large proportion of the population. Full-Text PDF

Fatores de risco e proteção para doenças crônicas: vigilância por meio de inquérito telefônico, VIGITEL, Brasil, 2007

This article describes the prevalence of risk and protective factors for chronic non-communicable diseases in Brazil, using data collected in 2007 through the telephone disease surveillance system (VIGITEL). We evaluated 54,252 adults residing in Brazil's State capitals and Federal District. Men showed higher rates of smoking, overweight, consumption of soft drinks and fatty meat, sufficient leisure-time physical activity, sedentary lifestyle, and binge drinking; women showed higher consumption of fruits and vegetables. For men with more schooling, the probability of smoking decreased by 42% and consumption of fatty meat decreased by 31%; overweight increased 86%, sedentary lifestyle 42%, regular consumption of fruits and vegetables 89%, and leisure-time physical activity 78%. For women with more schooling, the probability of smoking decreased 31%, overweight 26%, and consumption of fatty meat 35%; sedentary lifestyle increased 76%, leisure-time physical activity 77%, regular consumption of fruits and vegetables 48%, and recommended consumption of fruits and vegetables 75%.

Prevalence and social distribution of risk factors for chronic noncommunicable diseases in Brazil

To assess risk factors for chronic noncommunicable disease (CND) and to identity social inequalities in their distribution among the adult Brazilian population. Study of CND risk factors (including tobacco use, overweight and obesity, low fruit and vegetable intake (LFVI), insufficient leisure-time physical activity (LTPA), sedentary lifestyle, and alcohol abuse, among other risks) in a probabilistic sample of 54 369 individuals from Brazil's 26 state capitals and Federal District, in 2006, using the Surveillance System of Risk and Protective Factors for Chronic Non-Communicable Diseases through Telephone Interviews (VIGITEL), a computer-assisted telephone interviewing (CATI) survey system, and calculated age-adjusted prevalence ratios for trends in education levels using Poisson regression with linear models. Men reported higher tobacco use, overweight, LFVI, sedentary lifestyle, and alcohol abuse versus women, but lower insufficient LTPA. In men, education was associated with increased overweight and sedentary lifestyle, but decreased tobacco use, LFVI, and insufficient LTPA. Among women, education was associated with decreased tobacco use, overweight, obesity, LFVI, and insufficient LTPA, but increased sedentary lifestyle. In Brazil, prevalence of CND risk factors (except insufficient LTPA) is higher in men. For both sexes, the CND risk factor prevalence ratio is influenced by level of education.

Capture-recapture methodology: an option for surveillance of non-communicable diseases in the elderly

Capture-recapture methodology is used in Ecology to estimate the total size of wild animal populations. This method can be used in Epidemiology to estimate the incidence and prevalence of communicable and non-communicable diseases in a relatively inexpensive and quick way. Surveillance systems based on the use of this methodology are a potential alternative for monitoring non-communicable diseases in Brazil. This paper presents a brief review of fundamental capture-recapture methodology and its applications to Epidemiology. We also present a theoretical model for implementation of a diabetes mellitus surveillance system in the elderly using publicly available morbidity and mortality data sources and the capture-recapture methodology.