Educational inequality in the occurrence of abdominal obesity:Pró-Saúde Study

Alves, Ronaldo Fernandes Santos; Faerstein, Eduardo

doi:10.1590/s0034-8910.2015049005786

Cited by 18 publications

(16 citation statements)

References 27 publications

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“…Still, some studies evidence the association between low schooling and high BMI 36 , in consonance with the present findings, suggesting that a higher level of education may favour healthier living habits, such as the intake of vegetables and fruits 37 and the regular practice of physical activity 38 .…”

Section: Discussionsupporting

confidence: 91%

Health Conditions Associated with Overweight in Climacteric Women

Marques

Freitas

Popoff

et al. 2019

Preprint

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31This study aims to investigate the association between health conditions and 32 overweight in climacteric women assisted by primary care professionals. It is a cross-33 sectional study conducted with 874 women from 40 to 65 years of age, selected by 34 probabilistic sampling between August 2014 and August 2015. In addition to the outcome 35 variable, other variables such as overweight/obesity, sociodemographic, reproductive, 36 clinical, eating and behavioural factors were evaluated. Descriptive analyses of the 37 variables investigated through their frequency distributions were performed. Then, 38 bivariate analyses were performed through Poisson regression. For the multiple analyses, 39 the hierarchical Poisson regression was used to identify factors associated with 40 overweight/obesity in the climacteric period. The prevalence of overweight/obesity was 41 74%. Attending public school (PR: 1.30 -95% CI 1.14 -1.50), low schooling (PR: 1.11 42 -95% CI 1.01 -1.23), gout (PR: 1.18 -95% CI 1.16-1.44), kidney disease (PR: 1.18 -43 95% CI 1.05 -1.32), metabolic syndrome -MS (PR: 1.19 -95% CI 1.05 -1.34) and fat 44 intake (PR: 1.12 -95% CI 1.02 -1.23) were considered risk factors for overweight. 45Having the first birth after 18 years (PR: 0.89 -95% CI 0.82 to 0.97) was shown to be a 46 protective factor for overweight and obesity. The presence of overweight and obesity is 47 associated with socio-demographic, reproductive, clinical and eating habits. 48 49 Introduction 50Brazil has been presenting a rapid process of demographic and epidemiological 51 transition, leading to the frequent occurrence of chronic-degenerative diseases¹. The 52 increase in the prevalence of overweight, represented by overweight and obesity, among 53 the elderly female population raises great concern in developed and developing countries. 3 54Since overweight and obesity are risk factors for adverse health events 2 such as 55 disturbances in lipid and glycidic metabolism, psychological stress and sleep alterations, 56 with increasing risk of cardiovascular diseases 3 , musculoskeletal disease, acute 57 myocardial infarction 4 , cancer 5 and worse quality of life in comparison to those who were 58 satisfied with their body weight 6 . 59Overweight and obesity have become a public health problem in the world. The 60 projection for 2025 is that about 2.3 billion adults are overweight, and more than 700 61 million are obese. According to a study conducted in 2016, the rate of overweight among 62 Brazilian women is 50.5%, increasing this frequency with age and up to 64 years 7 . 63Epidemiological data are still scarce associating excess weight with behavioural 64 and clinical variables in climacteric women 8 , using probabilistic samples 9 . Considering 65 that climacteric is an important period of the women life cycle, and that this period is 66 related to the potential peak of fat mass and obesity in this group, the current study aimed 67 to investigate the association between health conditions and excess of weight ratio in 68 climacteri...

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Section: Discussionsupporting

confidence: 91%

Health Conditions Associated with Overweight in Climacteric Women

Marques

Freitas

Popoff

et al. 2019

Preprint

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“…In Brazil, in a study involving data from 3117 subjects, the prevalence of AO was found to be 26 and 73%, respectively, in women aged 24-34 years and 55-65 years. In men, the prevalence of AO was found to be 16.9% (24-34 years) and 27.2% (55-65 years) [20].…”

Section: Prevalence Of Abdominal Obesitymentioning

confidence: 94%

“…Also, recent studies show a higher prevalence of AO in women than men, in all ages. There is a proportional increase in the accumulation of fat in the abdominal region as people get older, but a stabilization or even a small decrease in the prevalence of AO in men after 60 years of age could be perceived [12,18,20]. In Brazil, in a study involving data from 3117 subjects, the prevalence of AO was found to be 26 and 73%, respectively, in women aged 24-34 years and 55-65 years.…”

Section: Prevalence Of Abdominal Obesitymentioning

confidence: 99%

Epidemiology of Abdominal Obesity

Olinto¹,

Theodoro²,

Canuto³

2017

Adiposity - Epidemiology and Treatment Modalities

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Abdominal obesity (AO) is associated with endothelial dysfunction, inflammation, insulin resistance, diabetes mellitus, hypercholesterolemia, metabolic syndrome, and cancer. AO is a multifactorial disorder arising from genetic, environmental, socioeconomic, and behavioral factors. Thus, in this chapter, we devote ourselves to the exercise of trying to explain the epidemiology of AO in adults. We showed the increasing prevalence of AO around the world, and a gender difference in this determination was observed. Among women, the population group who is the most affected by AO, a higher prevalence of AO is observed in individuals living in low-or middle-income countries (LMIC), who are older, multiparous, and in the menopausal transition, and who belong to the poorest strata and have lower educational level. While among men, the risk of AO is positively associated with socioeconomic status, particularly in LMIC. Regarding behavioral factors (eating frequency, sleep duration, physical activity, and smoking), gender differences are difficult to be detected due to the lack of studies investigating their association with AO according to sex. However, the current evidence suggests that men benefit more from consuming a greater number of meals a day and women are more affected by the harmful effects of physical inactivity. We argued AO, despite biological conditions associated with behavior factors, should be examined as an important issue of gender inequality in health, possibly mediated by socioeconomic and behavioral differences between men and women.

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“…The RII (logit link) and SII (identity link) are also based on regression models, but the independent variable (exposure) is defined from the cumulative relative frequency of the study population according to education levels. Differently from the OR, which assigns ordinal values to individuals from the respective educational levels, the RII and SII attribute numerical scores which consider the population size related to the various categories of education, as described by Alves e Faerstein (2015) [25]:Where k is the (ordinal) index of the education strata; f k is the k ’s group absolute frequency, and N is the total of individuals in the population. The ordering started from the most educated and the numeric score was calculated separately for each sociodemographic subgroup.…”

Section: Methodsmentioning

confidence: 99%

Educational inequalities in hypertension: complex patterns in intersections with gender and race in Brazil

Alves

Faerstein

2016

Int J Equity Health

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BackgroundHypertension is a major public health issue worldwide, but knowledge is scarce about its patterns and its relationship to multiple axes of social disadvantages in Latin American countries. This study describes the educational inequality in the prevalence of hypertension in Brazil, including a joint stratification by gender and race.MethodsWe analyzed interview-based data and blood pressure measurements from 59,402 participants aged 18 years or older at the 2013 Brazilian National Health Survey (PNS). Sociodemographic characteristics analyzed were gender (male, female), racial self-identification (white, brown, black), age (5-years intervals), and educational attainment (pre-primary, primary, secondary, tertiary). Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, and/or self-reported use of antihypertensive medications in the last 2 weeks. We used logistic regression to evaluate the age-adjusted prevalences of hypertension (via marginal modeling), and pair-wise associations between education level and odds of hypertension. Further, the educational inequality in hypertension was summarized through the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). All analyses considered the appropriate sampling weights and intersections with gender, race, and education.ResultsAge-adjusted prevalence of hypertension was 34.0 % and 30.8 % among men and women, respectively. Black and brown women had a higher prevalence than whites (34.5 % vs. 31.8 % vs. 29.5 %), whereas no racial differences were observed among men. White and brown, but not black women, showed graded inverse associations between hypertension and educational attainment; among men, non-statistically significant associations were observed in all racial strata. The RII and SII estimated inverse gradients among white (RII = 2.5, SII = 18.1 %) and brown women (RII = 2.3, SII = 14.5 %), and homogeneous distributions of hypertension in educational subgroups among black women and among men.ConclusionIn this representative sample of Brazilian adults, the association between educational attainment and hypertension was influenced by gender and race – a topic still poorly understood. Our findings highlight the importance of assessing intersections of multiple sociodemographic characteristics in health inequalities research. The use of comprehensive measures of inequality, such as RII and SII, provide useful insights for monitoring health inequalities in an intersectional perspective.

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Educational inequality in the occurrence of abdominal obesity:Pró-Saúde Study

Cited by 18 publications

References 27 publications

Health Conditions Associated with Overweight in Climacteric Women

Health Conditions Associated with Overweight in Climacteric Women

Epidemiology of Abdominal Obesity

Educational inequalities in hypertension: complex patterns in intersections with gender and race in Brazil

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