Objective: To analyze the spatial distribution of the prevalence of leisure-time physical activity (LTPA) in a Brazilian urban area and its association with the characteristics of the physical and social environments. Methods: A cross-sectional study conducted with data from the Surveillance System for Risk and Protective Factors for Chronic Diseases from the years 2008–2010, in Belo Horizonte, state of Minas Gerais, Brazil. The outcome was the practice of LTPA and the independent variables were residential and population density, the density of places for physical activity, homicide rates, average family income, and health vulnerability index. The spatial scanning technique was employed to identify clusters with a high prevalence of PA at leisure time. The Mann-Whitney test was used to compare variables inside and outside the cluster. Results: The sample included 5,779 participants, 33.3% (SE = 0.73) of whom reported sufficient PA during leisure time. We identified a significant cluster of a high prevalence of LTPA. After adjustments, the cluster presented a radius of 3,041.99 meters and 603 individuals, and 293 (48.6%) of them reported sufficient LTPA. The probability of performing sufficient LTPA in the cluster was 27% higher (PR = 1.27; p = 0.002) than in the coverage areas of primary healthcare units outside the cluster. There was a higher density of places for LTPA practice, higher population and residential density, and higher family income in the cluster. Conclusion: The results evidenced a cluster of high prevalence of LTPA in a privileged physical and socioeconomic environment in Belo Horizonte, even after adjustments, demonstrating that reducing inequalities can increase LTPA.
Objective: To analyze the contextual factors associated with type II diabetes mellitus in Belo Horizonte City. Methods: Cross-sectional study with 5,779 adults living in Belo Horizonte City, participating in the Risk and Protection Factors Surveillance System for Chronic Diseases through Telephone Survey (Vigitel), in 2008, 2009, and 2010. Multilevel regression models were used to test the association between contextual indicators of physical and social environments, and self-reported diagnosis of diabetes, adjusted for individual sociodemographic and lifestyle factors. Descriptive analyzes and multilevel logistic regression models were used, considering a 5% significance level. Results: The prevalence of diabetes was 6.2% (95%CI 5.54 – 6.92), and 3.1% of the variability of chance of presenting diabetes were explained by contextual characteristics. Living in areas with high density of private places for physical activity and high income was associated with a lower chance of having diabetes. The areas with high level of social vulnerability were strongly associated with the chance of presenting diabetes, adjusted for individual characteristics. Conclusion: Characteristics of physical and social environments were associated with the chance of diabetes occurrence. Urban centers with opportunities to adopt healthy behaviors can help to reduce the occurrence of diabetes and its complications.
Background Hypertension is the main risk factor for cardiovascular diseases, contributing significantly to the increase in the number of deaths and disabilities worldwide. Moreover, hypertension control is a major action for NCDs prevention. Although pharmacological treatment has been shown effective, high rates of uncontrolled hypertension remain. The objective is to estimate the prevalence of uncontrolled arterial hypertension and the factors associated to this outcome in a representative adult Brazilian population under a pharmacological treatment. Methods This is a cross-sectional study conducted with 10,016 Brazilian adults over 18 years old who participated in the National Health Survey in Brazil carried-out in 2013. The sample comprised of residents from all Federative Units, Poisson multivariate regression was used to calculate the prevalence ratio (PR) and 95% confidence interval. Results 45% (95% CI: 44; 48) of hypertensive adults under drug treatment have uncontrolled blood pressure levels. Female gender [PR = 0.92; CI: 0.85; 0.99] and not having previous hospitalizations due to complications from hypertension or other causes [PR = 0.86; CI: 0.78; 0.94] were associated to low the prevalence of uncontrolled blood pressure. Participants aged 60 years old or more [PR = 1.31; CI:1.04; 1.64], who self-declared as black [PR = 1.19; CI: 1.04; 1.36], without health insurance [PR = 1.15; CI: 1.05; 1.27] and not attending the health service because of arterial hypertension [PR = 1.10; CI:1.01; 1.20)] presented higher prevalence of uncontrolled blood pressure. Conclusions The prevalence of uncontrolled hypertension among Brazilian adults was high among the male gender, black people, elderly, without previous hospitalizations, without health insurance and not regularly attending the health service. These results may alert the need for a reassessment of the assistance provided, in addition to raising awareness of a possible change in public policies in these groups. Key messages Evidence the magnitude of people who are at risk of hypertension even under pharmacological treatment. Highlight inequities related to the uncontrol of hypertension.
The study aimed to analyze the spatial distribution of sedentary behavior and unhealthy eating habits, and to assess its relationship with the neighborhood environment. Cross-sectional study with data of Surveillance System of Risk and Protective Factors for Chronic Diseases, carried out in Belo Horizonte, Minas Gerais. Watching television for four hours or more per day was identified as sedentary behavior. Unhealthy eating habits were defined based on regular consumption of sodas, excess fat meat, and red meat, and irregular consumption of fruits and vegetables. Georeferenced data of places for physical activity, food establishments, population and residential density, homicide rate, mean total income, and social vulnerability index were entered into the Vigitel database. The coverage area by basic health units was used as the geographical unit of neighborhood. SaTScan was used to analyze the spatial distribution. Spatial analysis identified a significant cluster of high prevalence of sedentary behavior and unhealthy eating habits, after adjusting for sociodemographic characteristics. The comparison of environmental characteristics inside and outside clusters showed significant differences in the physical and social environment. Physical and social environment might be related to clusters of high prevalence of sedentary behavior and unhealthy eating habits.
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