Progress and setbacks in socioeconomic inequalities in adolescent health-related behaviours in Brazil: results from three cross-sectional surveys 2009-2015

Author(s)

Azeredo, Catarina Machado ^[1] ; de Rezende, Leandro F. M. ^[2] ; Mallinson, Poppy Alice Carson ^[3] ; Ricardo, Camila Zancheta ^[2] ; Kinra, Sanjay ^[3] ; Levy, Renata B. ^[2] ; Barros, Aluisio J. D. ^[4]

Affiliation

^[1] Univ Fed Uberlandia, Fac Med, Curso Nutr, Uberlandia, MG - Brazil

^[2] Univ Sao Paulo, Fac Med, Dept Med Prevent, Sao Paulo - Brazil

^[3] London Sch Hyg & Trop Med, Fac Epidemiol & Populat Hlth, Dept Noncommunicable Dis Epidemiol, London - England

^[4] Fed Univ Pelotas UFPel, Postgrad Programme Epidemiol, Pelotas - Brazil

• Document type: Journal article
• Source: BMJ OPEN; v. 9, n. 3 JUN 2019.
• Web of Science Citations: 1

Abstract

Objectives Despite some progress, Brazil is still one of the most unequal countries, and the extent of socioeconomic inequalities in adolescent health is unclear. We assessed trends in socioeconomic inequalities in adolescent's health-related behaviours in Brazil between 2009 and 2015. Design We used cross-sectional data from the Brazilian National Survey of School Health carried out in 2009, 2012 and 2015. Setting Brazilian state capitals. Participants Students attending ninth grade from public and private schools in Brazilian state capitals in 2009 (60 973 students), 2012 (61 145 students) and 2015 (51 192 students). Main outcome measure We assessed 12 health-related behaviours (irregular fruit, vegetables and bean consumption; regular soft drink consumption; irregular physical activity; alcohol, drug and tobacco use; unsafe sex; involvement in gun fights; bullying victimisation and domestic violence victimisation), under the broad domains of lifestyle risk behaviours, engagement in risky activities and exposure to violence. Socioeconomic status was assessed through an asset-based wealth index derived from principal component analysis. Absolute and relative inequalities in these health behaviours and inequalities trends were investigated. Results From 2009 to 2015, prevalence of certain harmful health-related behaviours increased, such as unsafe sex (21.5% to 33.9%), domestic violence (9.5% to 16.2%), bullying victimisation (14.2% to 21.7%) and irregular consumption of beans (37.5% to 43.7%). Other indicators decreased: alcohol use (27.1% to 23.2%), irregular physical activity (83.0% to 75.6%) and consumption of soft drinks (37.2% to 28.8%). Over the period, we found consistent evidence of decreasing health inequalities for lifestyle behaviours (fruit, bean and soft drink consumption) and alcohol use, set against increasing inequalities in violence (domestic violence, fights using guns and bullying victimisation). Conclusion Socioeconomic inequality increased in the violence domain and decreased for lifestyle behaviours among Brazilian adolescents. Widening gaps in violence domain urge immediately policy measures in Brazil. (AU)

• FAPESP's process: 16/21390-0 - Burden of cancer attributable to lifestyle risk factors in Brazil
• Grantee: Leandro Fórnias Machado de Rezende
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• FAPESP's process: 14/25614-4 - Physical inactivity and cancer: from evaluation of etiological evidence to public health impact
• Grantee: Leandro Fórnias Machado de Rezende
• Support Opportunities: Scholarships in Brazil - Doctorate