Sheila Rizzato Stopa

Consumo abusivo e dependência de álcool em população adulta no Estado de São Paulo, Brasil

OBJETIVO: Descrever as prevalencias de consumo abusivo e dependencia de alcool em populacao adulta de 20 a 59 anos no Estado de Sao Paulo, e suas associacoes com variaveis demograficas e socioeconomicas. METODOS: Inquerito domiciliar do tipo transversal (ISA-SP), em quatro areas do Estado de Sao Paulo: a) Regiao Sudoeste da Grande Sao Paulo, constituida pelos Municipios de Taboao da Serra, Itapecerica da Serra e Embu; b) Distrito do Butanta, no Municipio de Sao Paulo; c) Municipio de Campinas e; d) Municipio de Botucatu. Foi considerado consumo abusivo de alcool a ingestao em dia tipico de 30 gramas ou mais de etanol para os homens, e 24 gramas ou mais para as mulheres. A dependencia de alcool foi caracterizada pelo questionario CAGE. Analises bivariadas e multivariadas dos dados foram realizadas a partir de Modelos de Regressao de Poisson. Todas as analises foram estratificadas por sexo. RESULTADOS: Em 1.646 adultos entrevistados, a prevalencia de consumo abusivo de alcool foi de 52,9% no sexo masculino e 26,8% no sexo feminino. Quanto a dependencia de alcool, foram observadas duas ou mais respostas positivas no teste CAGE em 14,8% dos homens e em 5,4% das mulheres que relataram consumir alcool. Isto corresponde a uma prevalencia populacional de dependencia de 10,4% nos homens e 2,6% nas mulheres. O consumo abusivo de alcool no sexo masculino apresentou associacao inversa a faixa etaria e associacao direta a escolaridade e ao tabagismo. No sexo feminino, observou-se associacao direta do consumo abusivo de alcool com a escolaridade e o tabagismo, e com as situacoes conjugais sem companheiro. A dependencia de alcool no sexo masculino associou-se a nao exercer atividade de trabalho e a baixa escolaridade. No sexo feminino nao houve associacao do CAGE com nenhuma das variaveis estudadas. CONCLUSOES: Pela alta prevalencia de consumidores e dependentes, e essencial a identificacao dos segmentos sociodemograficos mais vulneraveis ao consumo abusivo e dependencia de alcool. As associacoes entre a dependencia/abuso e nao estar exercendo atividade de trabalho, no sexo masculino, e a maior prevalencia em mulheres de escolaridade universitaria, sugerem componentes para programas de intervencao e controle.

A Cobertura da Estratégia de Saúde da Família (ESF) no Brasil, segundo a Pesquisa Nacional de Saúde, 2013

OBJECTIVE to present Family Health Strategy (ESF) coverage according to the National Health Survey (PNS), comparing to administrative data and previous coverage of the National Household Sample Survey (PNAD 2008), and describe the frequencies of home visiting teams. METHODS it was compared data from 2013 according to PNS and data from the Ministry of Health and the National Household Sample Survey (PNAD 2008). Home visiting indicators of PNS were stratified by education and Major Regions. RESULTS the proportion of households registered in Family Health Teams in Brazil was 53.4% (95%CI: 52.1-54.6), being higher in rural areas and in the Northeast. The proportion of residents in registered households was 56.2%, similar to the Ministry of Health (56.4%) and showed growth compared to PNAD 2008 (50.9%). There was variation between regions, UF and capitals. People with lower education level have received more home visiting monthly. DISCUSSION the ESF is an important promoter of health equity and its coverage and scope increase is successful in the country.

Smoking trend indicators in Brazilian capitals, 2006-2013

This study aims to analyze the trend of indicators related to smoking in the capitals of Brazil from 2006 to 2013. Information on smoking trends extracted from the survey of risk and protective factors for chronic non-communicable diseases (NCDs) are analyzed through telephone interviews - VIGITEL conducted from 2006-2013 for the adult population in Brazilian capitals. To estimate the trend, the simple linear regression model was used. The prevalence of smokers in Brazil showed a relative reduction of 0.62% for each year of the survey, ranging from 15.6% in 2006 to 11.3% in 2013. A decrease was observed in both sexes in all age ranges except between 55 and 64 years in all education levels and regions. The total population of former smokers remained stable, with a reduction for men. Smoking 20 or more cigarettes per day decreased from 4.6% (2006) to 3.4% (2013), or 0.162 percentage points per year. Passive smoking at home decreased among women 13.4% (2009) to 10.7% (2013), a reduction of 0.72% per annum. Passive smoking at work has remained stable over the period. The smoking trend reduced in the period in most indicators, reflecting the importance of the tobacco control actions in the country.

Prevalência de diabetes autorreferido no Brasil: resultados da Pesquisa Nacional de Saúde 2013

OBJECTIVE: to estimate the prevalence of self-reported diabetes in Brazil, describing it according to sociodemographic characteristics. METHODS: this was a descriptive study of prevalence of medically diagnosed diabetes in adults (aged ≥18 years), using National Health Survey data, a household survey conducted in Brazil in 2013. RESULTS: 62,202 subjects were interviewed; reported disease prevalence was 6.2% (95%CI 5.9-6.6). It was greater in women (7.0%; 95%CI 6.5-7.5) than men (5.4%; 95%CI 4.8-5.9) and among people living in urban areas (6.5%; 95%CI 6.1-6.9) rather than rural areas (4.6%; 95%CI 4.0-5.2). Some nine million people are estimated to have diabetes in Brazil, around 3.5 million of whom are aged 65 years or more. CONCLUSION: the results from National Health Survey were consistent with other research conducted, and show an elevated number of people diagnosed as having diabetes, especially in urban areas.

A vigilância e o monitoramento das principais doenças crônicas não transmissíveis no Brasil - Pesquisa Nacional de Saúde, 2013

OBJECTIVE To describe the major noncommunicable diseases (NCDs) in Brazil, according to the information collected from individuals aged 18 years or older. METHODS Data from the National Health Survey (PNS), 2013, a transversal population-based study, were used. The proportions of each NCD were calculated and presented according to sex, with a 95% confidence interval (95%CI), with the absolute values. RESULTS Of the total respondents, 45.1% reported presenting at least one NCD. The region with the highest prevalence of NCDs was the South (52.1%). Hypertension showed the highest prevalence among NCDs, with 21.4%, followed by chronic back problem (18.5%), depression (7.6%), arthritis (6.4%), and diabetes (6.2%). The intense/very intense degree of limitation showed a higher prevalence of other mental illnesses (37.6%) and cerebrovascular accident (25.5%). CONCLUSION The improvement of health services is essential for an effective response to the double burden of illness in the middle- and low-income countries.

Prevalência e distribuição sociodemográfica de marcadores de alimentação saudável, Pesquisa Nacional de Saúde, Brasil 2013

OBJETIVO:Descrever prevalencias de marcadores de consumo alimentar saudavel e sua distribuicao segundo variaveis sociodemograficas na populacao adulta brasileira.METODOS:Estudo transversal descritivo com dados da Pesquisa Nacional de Saude (PNS), 2013, coletados por meio de entrevistas em 64.348 domicilios. Os marcadores de alimentacao saudavel foram consumo regular de feijao e de peixe e consumo recomendado de frutas e hortalicas. Estimaram-se as prevalencias (%) e intervalos de confianca de 95% (IC95%).RESULTADOS:O consumo regular de feijao foi referido por 71,9% (IC95%: 71,2-72,6), de frutas e hortalicas por 37,3% (IC95%: 36,4-38,1) e de peixe por 54,6% (IC95%: 53,7-55,5) da populacao, sendo a distribuicao dos marcadores alimentares influenciada pela idade, sexo, nivel de instrucao, raca/cor da pele e local de residencia dos entrevistados.CONCLUSAO:Os achados confirmaram elevada prevalencia de consumo de feijao, peixe e frutas e hortalicas na dieta da populacao adulta brasileira.OBJECTIVE:to describe the prevalence of healthy eating markers and their association with sociodemographic variables among Brazilian adults.METHODS:cross-sectional study using data from the National Health Survey (PNS 2013) conducted in 64,348 households. Healthy eating markers evaluated were: regular consumption of beans and fish and recommended consumption of fruit and vegetables. Prevalence (%) of these markers and their 95% confidence intervals (95%CI) were estimated.RESULTS:regular bean consumption was reported by 71.9% (95%CI: 71.2-72.6), fruit and vegetables by 37.3% (95%CI: 36.4-38.1) and fish by 54.6% (95%CI: 53.7-55.5) of the population. Food marker distribution was influenced by age, sex, schooling, ethnicity and place of residence of respondents.CONCLUSION:the findings confirmed a high prevalence of consumption of beans, fish and fruit and vegetables in the diet of Brazilian adults.

Fatores de risco e proteção para doenças crônicas por inquérito telefônico nas capitais brasileiras, Vigitel 2014

Objective: To describe the prevalence of risk and protective factors for chronic diseases in Brazilian adult population in 2014 and investigate the associated sociodemographic factors. Methods: Analyses were performed based on data from telephone interviews (Vigitel 2014) on probabilistic samples of adult population (≥ 18 years old) from the capitals of the 26 Brazilian States and the Federal District, living in households with landline phones. Prevalence is presented by gender, age and educational level, and adjusted prevalence ratios (PR) are estimated using Poisson Regression model. Results: Among the 40.853 adults who were interviewed, 10.8% were smokers and 21.2% ex-smokers. Among the respondents, 16.5% reported alcohol abuse and 52.5% were overweight, factors that were more frequent among men. The prevalence of recommended intake of fruits and vegetables was 24%, intake of sweets was 18.1% and replacements of main meals for snacks was 16.2%, factors that were higher among women. Leisure time physical activity reached 35.3% and increased with the level of education. Hypertension was the most frequent disease achieving 24.8%, which was higher among women and increased with age. Conclusion: The results from Vigitel 2014 indicate that risk factors are, in general, more frequent among men, older adults and less educated individuals, characterizing the socioeconomic and cultural dimensions in determining chronic diseases.OBJECTIVE To describe the prevalence of risk and protective factors for chronic diseases in Brazilian adult population in 2014 and investigate the associated sociodemographic factors. METHODS Analyses were performed based on data from telephone interviews (Vigitel 2014) on probabilistic samples of adult population (≥ 18 years old) from the capitals of the 26 Brazilian States and the Federal District, living in households with landline phones. Prevalence is presented by gender, age and educational level, and adjusted prevalence ratios (PR) are estimated using Poisson Regression model. RESULTS Among the 40.853 adults who were interviewed, 10.8% were smokers and 21.2% ex-smokers. Among the respondents, 16.5% reported alcohol abuse and 52.5% were overweight, factors that were more frequent among men. The prevalence of recommended intake of fruits and vegetables was 24%, intake of sweets was 18.1% and replacements of main meals for snacks was 16.2%, factors that were higher among women. Leisure time physical activity reached 35.3% and increased with the level of education. Hypertension was the most frequent disease achieving 24.8%, which was higher among women and increased with age. CONCLUSION The results from Vigitel 2014 indicate that risk factors are, in general, more frequent among men, older adults and less educated individuals, characterizing the socioeconomic and cultural dimensions in determining chronic diseases.

Prevalência de hipertensão arterial autorreferida na população brasileira: análise da Pesquisa Nacional de Saúde, 2013

Objective: to describe self-reported hypertension prevalence in Brazilian adults (aged 18 or over) for the entire country and by urban/rural areas, regions and states. Methods: this was a descriptive study using 2013 National Health Survey data from a sample of 60,202 adults; prevalence and respective 95% confidence intervals (95%CI) were calculated according to sex, age, schooling and race/skin color. Results: hypertension prevalence was 21.4% (95%CI:20.8-22.0); prevalence was highest among women (24.2%; 95%CI:23.4-24.9), individuals aged over 75 (55.0%; 95%CI:51.8-58.3), those with less schooling (31.1%; 95%CI:30.1-32.2), black skin color (24.2%; 95%CI:22.2-26.3), those living in urban areas (21.7%; 95%CI:21.0-22.3), in the state of Rio Grande do Sul (24.9%; 95%CI:22.7-27.1) and in the Southeast region (23.3%; 95%CI:23.3-24.3). Conclusion: hypertension prevalence was high in Brazilian adults, mainly among those aged 60 or over, with less schooling, living in urban areas and in the Southeast region.

Tendência temporal dos indicadores de excesso de peso em adultos nas capitais brasileiras, 2006-2013

The scope of this article is to analyze time trends in excess weight (overweight, obesity and class III obesity) among adults (≥ 18 years of age) in Brazilian capitals between 2006 and 2013. It is a study of temporal trends in excess weight indicators using data from the telephone-based Surveillance System of Risk and Protective Factors for Chronic Non-Communicable Diseases (Vigitel). The Prais regression model was performed. In 2013, the following statistics were observed in the adult population: overweight in 32.2%; obesity in 17.5%, and class III obesity in 1.5%. From 2006 to 2013, there was a significant increase in major indicators, for sex, age group, level of schooling (years) and regions. Overweight and obesity indicators demand attention since they result in a burden on the individual, society and health services.

Prevalência do autorrelato de depressão no Brasil: resultados da Pesquisa Nacional de Saúde, 2013

OBJECTIVE To describe the prevalence of self-reported previous medical diagnosis of depression in the adult (18 years or older), Brazilian population according to sociodemographic factors. METHODS Data from the 2013 National Health Survey, a population-based survey, were used. The self-reported previous medical diagnosis of depression, received at some point during the patients life, was investigated. Prevalence and their respective confidence intervals of 95% (CI 95%) were calculated, stratified by gender, age group, education level, race/skin color, for Brazil, place of residence, major regions, federative units and capitals. RESULTS The prevalence of self-reported diagnosis of depression in adults in Brazili was of 7.6% (95%CI 7.2 - 8.1), being higher in women (10.9%; 95%CI 10.3 - 11.6) and among people between 60 and 64 years old (11.1%; 95%CI 9.1 - 13.1). Furthermore, the highest prevalence was among individuals with no formal education or those with incomplete primary education 8.6% (95%CI 7.9 - 9.3), for those with complete tertiary education 8.7% (95%CI 7.5 - 9,9); and for those who declared themselves as white (9.0%; 95%CI 8.3 - 9.6). For place of residence, the self-report was higher in individuals living in urban areas (8.0%; 95%CI 7.5 - 8.4) and in the South (12.6%; 95%CI 11.2 - 13.9). CONCLUSION The analysis shows the importance of understanding the access to the diagnosis of depression in Brazil. It is necessary to improve access to quality health services throughout the country to include the underprivileged population. Reducing disparities in access to health services is crucial to ensuring that social rights are universal and equal.