An invisible villain: high perceived stress, its associated factors, and possible consequences in a population-based survey in southern Brazil

Abstract

Introduction Much of the evidence on the relationship between stress, lifestyle, and other physical and mental health outcomes comes from studies conducted in high-income countries. There is therefore a need for research among populations in low and middle-income settings. Objectives To measure stress levels and identify factors associated with a high stress level and its consequences for health. Methods This was a population-based cross-sectional study carried out in 2016 with adults aged 18 years or older in a municipality in southern Brazil. A two-stage sampling strategy based on census tracts was used. Stress levels were measured with the Perceived Stress Scale (PSS-14) and classified into quartiles. The impact of the highest stress levelon each outcome was assessed with etiologic fractions (EF). Results The most stressed groups were: females (PR = 1.51, 95%CI 1.25-1.81), younger people (PR = 1.76, 95%CI 1.26-2.46), middle-aged individuals (PR = 1.60, 95%CI 1.17-2.19), those with lower schooling (PR = 1.56, 95%CI 1.20-2.02), the physically inactive (PR = 1.51, 95%CI 1.20-1.91), people who spent three or more hours watching television per day (PR = 1.29, 95%CI 1.12-1.50), and those with food insecurity (PR = 1.44, 95%CI 1.19-175). Possible consequences of high stress level were regular or poor self-perception of health (EF = 29.6%), poor or very poor sleep quality (EF = 17.3%), lower quality of life (EF = 45.6%), sadness (EF = 24.2%), and depressive symptoms (EF = 35.8%). Conclusions Stress plays an important role in several domains of health. Both public policies that target reduction of inequalities and specific stress-management interventions can reduce stress levels in populations, thereby decreasing the burden of other negative physical and mental health outcomes related to stress.

Household food insecurity before and during COVID-19 pandemic and its association with perceived stress: population-based studies

“…Higher prevalence of food insecurity was found among the less educated, low-income, and non-white individuals. Similar results before and during the pandemic were found in other studies 5,6,41,51,52,53 .…”

“…A study carried out in 2016 (prior to COVID-19) in another city from Southern Brazil found similar results. Food insecurity increased stress prevalence by 44% (95%CI: 1.19; 1.75) 41 . Similarly, the same association was also found in a systematic review and meta-analysis with prepandemic data from cross-sectional studies (odds ratio -OR = 1.34; 95%CI: 1.24; 1.44) 16 .…”

Association between food insecurity and major depressive episodes amid Covid-19 pandemic: results of four consecutive epidemiological surveys from southern Brazil

“…In Brazil, specifically, few population-based studies have investigated the association between FI and mental health disorders in overall population. Demenech et al (42) found that FI status increased the prevalence of high perceived stress in 44 % in the city of Rio Grande, also located in Southern Brazil. In addition, Dumith et al (43) , using population-based data from the city of Rio Grande as well, revealed that FI status was associated with higher prevalence of suicidal thoughts (adjusted prevalence ratio = 1•75; 95 % CI 1•13, 2•72).…”