Educational disparities in hypertension, diabetes, obesity and smoking in Brazil: a trend analysis of 578 977 adults from a national survey, 2007–2018

Dulgheroff, Pedro Toteff; Silva, Luciana Saraiva da; Rinaldi, Ana Elisa Madalena; Rezende, Leandro F. M.; Marques, Emanuele Souza; Azeredo, Catarina Machado

doi:10.1136/bmjopen-2020-046154

Cited by 12 publications

(14 citation statements)

References 38 publications

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“…In Brazil, educational attainment is a good proxy of socioeconomic status. People without access to formal education or those with < 7 years of education (elementary school only) are more likely to have lower socioeconomic status and worse health outcomes 15 , 16 . These results corroborate the projected prevalence of obesity in the United States by 2030: 55.6% of participants with household income below $20.000/year will be living with obesity vs 41.7% in participants with higher household income (≥ $50.000/year).…”

Section: Discussionmentioning

confidence: 99%

Time trends and projected obesity epidemic in Brazilian adults between 2006 and 2030

Estivaleti

Guzmán-Habinger

Lobos³

et al. 2022

Sci Rep

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We examined time trends and projected obesity epidemic in Brazilian adults between 2006 and 2030 by sex, race/skin color, educational attainment, and state capitals. Self-reported body weight and height of 730,309 adults (≥ 18 years) from the Vigitel study were collected by telephone interview between 2006 and 2019. A multinomial logistic regression model was used to predict the prevalence of body mass index (BMI) categories as a function of time by 2030. The prevalence of obesity increased from 11.8% in 2006 to 20.3% in 2019. The projected prevalences by 2030 are estimated to be 68.1% for overweight, 29.6% for obesity, and 9.3% for obesity classes II and III. Women, black and other minority ethnicities, middle-aged adults, adults with ≤ 7 years of education, and in Northern and Midwestern capitals are estimated to have higher obesity prevalence by 2030. Our findings indicate a sustained increase in the obesity epidemic in all sociodemographic subgroups and across the country. Obesity may reach three out of 10 adults by 2030.

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Section: Discussionmentioning

confidence: 99%

Time trends and projected obesity epidemic in Brazilian adults between 2006 and 2030

Estivaleti

Guzmán-Habinger

Lobos³

et al. 2022

Sci Rep

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“…Food consumption is structurally conditioned by social inequality ( 6 ) and, therefore, not homogeneously distributed among individuals. Unequal access to economic resources, food supply and retail markets make those less economically privileged more vulnerable to a low-quality diet and an increased burden of its negative effects ( 7 , 8 ). Thus, analyzing the global trend of food consumption may disguise differences among social groups over time.…”

Section: Introductionmentioning

confidence: 99%

“…The social gradient in food consumption in high-income countries shows a clear pattern of low-income individuals presenting a higher consumption of unhealthy food and lower consumption of healthy food compared to high-income individuals ( 8 ). In middle-income countries, some complex relations have been reported, with less educated individuals eating both less healthy food, such as fruits and vegetables, and unhealthy food, such as soft drinks, compared to those located upper in the social ladder ( 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

Changes in socioeconomic inequalities in food consumption among Brazilian adults in a 10-years period

Louzada

Costa²,

Costa

et al. 2022

Front. Nutr.

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ObjectiveTo evaluate changes in socioeconomic inequalities in food consumption in Brazil over a 10-year period.MethodsData on 24-h recalls of adults (aged 20 years or more) from the 2008/9 (n = 26,327) and 2017/8 (n = 37,689). Brazilian Dietary Survey were analyzed. We used the Nova classification system to group food items and estimate the percentage of total energy from ultra-processed foods and plant-based natural or minimally processed foods. For sex and area of residence, we calculated the percentage points (p.p.) difference between the estimates for women and men, and rural and urban populations. Negative values indicate higher consumption among men or urban residents, positive values indicate higher consumption among women or rural residents, and zero indicates equality. For education and wealth levels we calculated the slope index of inequality (SII). The SII varies from −100 to 100, with positive values indicating higher consumption among more educated or wealthiest groups, negative values indicating higher consumption among less educated or poorest groups, and zero equality.ResultsOver the period, we observed a reduction in the percentage of total energy from plant-based natural/minimally processed foods from 13.0 to 12.2% and an increase in that of ultra-processed foods from 17.0 to 18.3%. The urban population and those in the wealthier and more educated groups presented higher consumption of ultra-processed foods and lower consumption of plant-based natural/minimally processed foods in both survey years. Over the 10-year period, there was an overall reduction of the socioeconomic inequalities, mainly explained by the greater increase in ultra-processed food consumption by the rural population and those from the poorest and less educated groups (difference for area −7.2 p.p. in 2008/9 and −5.9 p.p. in 2017/8; SII for education 17.7 p.p. in 2008/9 and 13.8 p.p. in 2017/8; SII for wealth 17.0 p.p. in 2008/9 and 11.2 p.p. in 2017/8).ConclusionSocioeconomic inequalities in food consumption decreased in Brazil, but it may lead to the overall deterioration of the dietary quality of the more vulnerable groups.

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“…Women were usually more affected by their SES and the higher it was the lower was their risk of developing diabetes compared to men. [49][50][51] Addo et al, did a study on Ghanian adults residing in Europe based on data derived from the multicenter Research on Obesity and Diabetes among African Migrants (RODAM). They found that diabetes prevalence decreased with increasing educational level in Ghanaian men and women in Europe and in men in urban Ghana; however, it increased with increasing level of education in men and women in rural Ghana.…”

Section: Diabetes Prevalence and Its Association With Ses In 2003 And...mentioning

confidence: 99%

Socioeconomic inequalities in diabetes prevalence: the case of South Africa between 2003 and 2016

2023

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Background Diabetes is a growing epidemic worldwide and the effect of socioeconomic status (SES) is frequently acknowledged in the literature. This study aims to compare the effect of SES on diabetes prevalence in South Africa between 2003 and 2016. In addition, vulnerable groups regarding diabetes development in 2016 will be identified. Methods Using DHS data there were 8,006 participants (59.19% women) in 2003 and 10,292 participants (59.42% women) in 2016. Logistic regression and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for diabetes by age, gender, educational level and place of residence. To identify vulnerable groups with high risk of developing diabetes in 2016, the method of p-value based regression tree analysis was applied using “wealth index” and “weight perception” as additional variables. Results There was an increase in diabetes prevalence from 3.86% in 2003 to 4.46% in 2016. Women had more risk of developing diabetes at both time points (27% in 2003 and 24% in 2016 more risk). Increase in age and living in urban areas were associated with more risk of developing diabetes at both time points. There was no specific pattern regarding risk of developing diabetes and educational level in case of women. However, men who completed secondary school or had a higher diploma or above had more risk of developing diabetes in 2016 (OR = 2.24 and 4.67 respectively). Vulnerable groups who have higher risk of developing diabetes in 2016 were participants aged “60 years or older” with a wealth index of “rich” or “richer”, followed by participants from the same age group who were “poor” or “poorer” and participants aged “40–59 years” with a wealth index of “rich” or “richer”. Subsequently were participants from the age group “15–39 years” with a weight perception of “overweight” or “obese”. Conclusion Diabetes prevalence increased in South Africa between 2003 and 2016. Main risk factors were age, gender and living in urban areas. Men with high educational level were more at risk of developing diabetes in 2016. Vulnerable groups in 2016 were participants 40 years and older, particularly with high SES. This was followed by younger participants who were obese or overweight.

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Educational disparities in hypertension, diabetes, obesity and smoking in Brazil: a trend analysis of 578 977 adults from a national survey, 2007–2018

Cited by 12 publications

References 38 publications

Time trends and projected obesity epidemic in Brazilian adults between 2006 and 2030

Time trends and projected obesity epidemic in Brazilian adults between 2006 and 2030

Changes in socioeconomic inequalities in food consumption among Brazilian adults in a 10-years period

Socioeconomic inequalities in diabetes prevalence: the case of South Africa between 2003 and 2016

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