Progress and setbacks in socioeconomic inequalities in adolescent health-related behaviours in Brazil: results from three cross-sectional surveys 2009–2015
ObjectivesDespite 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.DesignWe used c...
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| Veröffentlicht in: | BMJ open 2019-03, Vol.9 (3), p.e025338-e025338 |
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| creator | Azeredo, Catarina Machado de Rezende, Leandro F M Mallinson, Poppy Alice Carson Ricardo, Camila Zancheta Kinra, Sanjay Levy, Renata B Barros, Aluisio J D |
| description | ObjectivesDespite 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.DesignWe used cross-sectional data from the Brazilian National Survey of School Health carried out in 2009, 2012 and 2015.SettingBrazilian state capitals.ParticipantsStudents 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 measureWe 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.ResultsFrom 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).ConclusionSocioeconomic 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. |
| doi_str_mv | 10.1136/bmjopen-2018-025338 |
| format | Article |
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We assessed trends in socioeconomic inequalities in adolescent’s health-related behaviours in Brazil between 2009 and 2015.DesignWe used cross-sectional data from the Brazilian National Survey of School Health carried out in 2009, 2012 and 2015.SettingBrazilian state capitals.ParticipantsStudents 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 measureWe 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.ResultsFrom 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).ConclusionSocioeconomic 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.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2018-025338</identifier><identifier>PMID: 30904861</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adolescent ; Alcohol ; Alcohol Drinking - epidemiology ; Behavior ; Brazil ; Child development ; Childrens health ; Classrooms ; Cross-Sectional Studies ; Epidemiology ; Exercise ; Female ; Food ; Health Behavior ; Health disparities ; Health surveillance ; Humans ; Inequality ; Lifestyles ; Male ; Middle schools ; Mortality ; Principal components analysis ; Private schools ; Public health ; Questionnaires ; Residence Characteristics - statistics & numerical data ; Response rates ; Risk-Taking ; Sexual Behavior - statistics & numerical data ; Socioeconomic Factors ; Students ; Students - statistics & numerical data ; Substance-Related Disorders - epidemiology ; Teenagers ; Trends ; Violence ; Violence - statistics & numerical data</subject><ispartof>BMJ open, 2019-03, Vol.9 (3), p.e025338-e025338</ispartof><rights>Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2019 Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b472t-87700abcbe256569e1b336c60e6bb4750789705d87b5fc474f0042e5cdb1506e3</citedby><cites>FETCH-LOGICAL-b472t-87700abcbe256569e1b336c60e6bb4750789705d87b5fc474f0042e5cdb1506e3</cites><orcidid>0000-0002-6189-4429</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://bmjopen.bmj.com/content/9/3/e025338.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://bmjopen.bmj.com/content/9/3/e025338.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27549,27550,27924,27925,53791,53793,77601,77632</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30904861$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Azeredo, Catarina Machado</creatorcontrib><creatorcontrib>de Rezende, Leandro F M</creatorcontrib><creatorcontrib>Mallinson, Poppy Alice Carson</creatorcontrib><creatorcontrib>Ricardo, Camila Zancheta</creatorcontrib><creatorcontrib>Kinra, Sanjay</creatorcontrib><creatorcontrib>Levy, Renata B</creatorcontrib><creatorcontrib>Barros, Aluisio J D</creatorcontrib><title>Progress and setbacks in socioeconomic inequalities in adolescent health-related behaviours in Brazil: results from three cross-sectional surveys 2009–2015</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>ObjectivesDespite 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.DesignWe used cross-sectional data from the Brazilian National Survey of School Health carried out in 2009, 2012 and 2015.SettingBrazilian state capitals.ParticipantsStudents 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 measureWe 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.ResultsFrom 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).ConclusionSocioeconomic 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.</description><subject>Adolescent</subject><subject>Alcohol</subject><subject>Alcohol Drinking - epidemiology</subject><subject>Behavior</subject><subject>Brazil</subject><subject>Child development</subject><subject>Childrens health</subject><subject>Classrooms</subject><subject>Cross-Sectional Studies</subject><subject>Epidemiology</subject><subject>Exercise</subject><subject>Female</subject><subject>Food</subject><subject>Health Behavior</subject><subject>Health disparities</subject><subject>Health surveillance</subject><subject>Humans</subject><subject>Inequality</subject><subject>Lifestyles</subject><subject>Male</subject><subject>Middle schools</subject><subject>Mortality</subject><subject>Principal components analysis</subject><subject>Private schools</subject><subject>Public health</subject><subject>Questionnaires</subject><subject>Residence Characteristics - statistics & numerical data</subject><subject>Response rates</subject><subject>Risk-Taking</subject><subject>Sexual Behavior - statistics & numerical data</subject><subject>Socioeconomic Factors</subject><subject>Students</subject><subject>Students - statistics & numerical data</subject><subject>Substance-Related Disorders - epidemiology</subject><subject>Teenagers</subject><subject>Trends</subject><subject>Violence</subject><subject>Violence - statistics & numerical data</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNks1uFSEYhidGY5vaKzAxJG7cTOVngBkXJtpYNWmiC10TYL7pcGSGU2BOUlfeg2tvrlci58emupINBJ7vhe_lraqnBJ8RwsRLM63CGuaaYtLWmHLG2gfVMcVNUwvM-cN766PqNKUVLqPhHef0cXXEcIebVpDj6tfnGK4ipIT03KME2Wj7LSE3oxSsC2DDHCZnywZcL9q77GB3qvvgIVmYMxpB-zzWEbzO0CMDo964sMQd9zbq786_QuWKxeeEhhgmlMcIgGwMKdUJbHZh1h6lJW7gJiGKcXf742fpjD-pHg3aJzg9zCfV14t3X84_1Jef3n88f3NZm0bSXLdSYqyNNUC54KIDYhgTVmAQphAcy7aTmPetNHywjWyG4gUFbntDOBbATqrXe931Yibot21F7dU6uknHGxW0U3-fzG5UV2GjRFEnQhaBFweBGK4XSFlNrrjjvZ4hLElR0klGW9Kwgj7_B10Vs4oBO0oQxkhHC8X21M6lCMPdYwhW2wSoQwLUNgFqn4BS9ex-H3c1f_67AGd7oFT_l-Jvx43AWQ</recordid><startdate>20190323</startdate><enddate>20190323</enddate><creator>Azeredo, Catarina Machado</creator><creator>de Rezende, Leandro F M</creator><creator>Mallinson, Poppy Alice Carson</creator><creator>Ricardo, Camila Zancheta</creator><creator>Kinra, Sanjay</creator><creator>Levy, Renata B</creator><creator>Barros, Aluisio J D</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6189-4429</orcidid></search><sort><creationdate>20190323</creationdate><title>Progress and setbacks in socioeconomic inequalities in adolescent health-related behaviours in Brazil: results from three cross-sectional surveys 2009–2015</title><author>Azeredo, Catarina Machado ; de Rezende, Leandro F M ; Mallinson, Poppy Alice Carson ; Ricardo, Camila Zancheta ; Kinra, Sanjay ; Levy, Renata B ; Barros, Aluisio J D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b472t-87700abcbe256569e1b336c60e6bb4750789705d87b5fc474f0042e5cdb1506e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Alcohol</topic><topic>Alcohol Drinking - epidemiology</topic><topic>Behavior</topic><topic>Brazil</topic><topic>Child development</topic><topic>Childrens health</topic><topic>Classrooms</topic><topic>Cross-Sectional Studies</topic><topic>Epidemiology</topic><topic>Exercise</topic><topic>Female</topic><topic>Food</topic><topic>Health Behavior</topic><topic>Health disparities</topic><topic>Health surveillance</topic><topic>Humans</topic><topic>Inequality</topic><topic>Lifestyles</topic><topic>Male</topic><topic>Middle schools</topic><topic>Mortality</topic><topic>Principal components analysis</topic><topic>Private schools</topic><topic>Public health</topic><topic>Questionnaires</topic><topic>Residence Characteristics - statistics & numerical data</topic><topic>Response rates</topic><topic>Risk-Taking</topic><topic>Sexual Behavior - statistics & numerical data</topic><topic>Socioeconomic Factors</topic><topic>Students</topic><topic>Students - statistics & numerical data</topic><topic>Substance-Related Disorders - epidemiology</topic><topic>Teenagers</topic><topic>Trends</topic><topic>Violence</topic><topic>Violence - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Azeredo, Catarina Machado</creatorcontrib><creatorcontrib>de Rezende, Leandro F M</creatorcontrib><creatorcontrib>Mallinson, Poppy Alice Carson</creatorcontrib><creatorcontrib>Ricardo, Camila Zancheta</creatorcontrib><creatorcontrib>Kinra, Sanjay</creatorcontrib><creatorcontrib>Levy, Renata B</creatorcontrib><creatorcontrib>Barros, Aluisio J D</creatorcontrib><collection>BMJ Journals (Open Access)</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Family Health Database (Proquest)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Psychology Journals</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Azeredo, Catarina Machado</au><au>de Rezende, Leandro F M</au><au>Mallinson, Poppy Alice Carson</au><au>Ricardo, Camila Zancheta</au><au>Kinra, Sanjay</au><au>Levy, Renata B</au><au>Barros, Aluisio J D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Progress and setbacks in socioeconomic inequalities in adolescent health-related behaviours in Brazil: results from three cross-sectional surveys 2009–2015</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2019-03-23</date><risdate>2019</risdate><volume>9</volume><issue>3</issue><spage>e025338</spage><epage>e025338</epage><pages>e025338-e025338</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>ObjectivesDespite 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.DesignWe used cross-sectional data from the Brazilian National Survey of School Health carried out in 2009, 2012 and 2015.SettingBrazilian state capitals.ParticipantsStudents 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 measureWe 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.ResultsFrom 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).ConclusionSocioeconomic 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.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>30904861</pmid><doi>10.1136/bmjopen-2018-025338</doi><orcidid>https://orcid.org/0000-0002-6189-4429</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Alcohol Alcohol Drinking - epidemiology Behavior Brazil Child development Childrens health Classrooms Cross-Sectional Studies Epidemiology Exercise Female Food Health Behavior Health disparities Health surveillance Humans Inequality Lifestyles Male Middle schools Mortality Principal components analysis Private schools Public health Questionnaires Residence Characteristics - statistics & numerical data Response rates Risk-Taking Sexual Behavior - statistics & numerical data Socioeconomic Factors Students Students - statistics & numerical data Substance-Related Disorders - epidemiology Teenagers Trends Violence Violence - statistics & numerical data |
| title | Progress and setbacks in socioeconomic inequalities in adolescent health-related behaviours in Brazil: results from three cross-sectional surveys 2009–2015 |
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