Temporal trends in behavioral risk and protective factors and their association with mortality rates: results from Brazil and Argentina

Abstract

Background Despite available information on trends in behavioral factors for Brazil and Argentina, little is known about the association of these trends with mortality. Understanding this association is important to avoid early deaths. Therefore, we aimed to evaluate temporal trends in behavioral risk and protective factors in Brazil and Argentina, and to assess their association with overall and cause-specific mortality rates. Methods Ecological study with data from two population surveys from Brazil and Argentina. Weighted prevalence of tobacco smoking, excessive alcohol consumption, fruit and vegetable consumption and physical activity for the 27 Brazilian state capitals and for the 23 Argentinean provinces were used as behavioral factors. Information on overall mortality as well as cardiovascular diseases and cancer mortality for the year 2015 was collected from national mortality banks of both countries. Estimated prevalence rates were used to describe trends in behavioral factors from 2006 to 2014 in Brazil, and from 2005 to 2013 in Argentina, while Pearson’s correlation and linear regression models were used to assess their association with overall and cause-specific mortality rates. Results Brazil presented improvements in behavioral risk and protective factors: sharp decrease in tobacco smoking prevalence (from 15 to 9%), increase in regular fruit and vegetable consumption (from 28 to 36%), and increase in physical activity (45 to 51%). In Argentina, results were more disappointing: small reduction in tobacco smoking (from 55 to 50%) and decrease in physical activity (from 55 to 45%). In both countries, excessive alcohol consumption remained stable, with increase only among women. The association between behavioral factors and mortality showed that in those Brazilian capitals with higher prevalence of regular consumption of fruits and vegetables, there were lower overall mortality rates. Stratification by gender revealed that significant results were only found among women. Conclusion Prevalence of regular consumption of fruits and vegetables increased in Brazilian capitals and was associated with lower overall mortality rate, suggesting a positive impact of Brazilian policies to improve dietary intake patterns on its population’s mortality. Approaches focusing on behavioral factors are especially needed in Argentina to reach similar results of those seen in Brazil.

Alcohol Consumption and Smoking During Covid-19 Pandemic: Association with Sociodemographic, Behavioral, and Mental Health Characteristics

“…It is an important result because Brazil has suffered with high rates of unemployment over the last few years, owing to its economic and political crisis, with younger individuals being the most affected ones [ 33 ]. As a result of several actions, e.g., warnings on cigarette packages and ban on cigarette advertisements in the media, Brazil has succeeded in combatting tobacco use, with considerable decrease in the prevalence of this behavior when compared to other South American countries, for example, Argentina [ 4 ]. From 2006 to 2014, there was a drop of more than five percentage points in the prevalence of tobacco use [ 4 ].…”

“…As a result of several actions, e.g., warnings on cigarette packages and ban on cigarette advertisements in the media, Brazil has succeeded in combatting tobacco use, with considerable decrease in the prevalence of this behavior when compared to other South American countries, for example, Argentina [ 4 ]. From 2006 to 2014, there was a drop of more than five percentage points in the prevalence of tobacco use [ 4 ]. However, the combination of high prevalence of unemployment and the consequences of the Covid-19 pandemic on people’s health can mitigate the decrease in the prevalence of cigarette smoking found in Brazil, particularly in younger populations.…”

“…Although there was a decline in cigarette smoking in the last years, its prevalence is still high with marked differences between males and females: 32.7% in men and 6.6% in women in 2019, accounting for 1.14 billion smokers worldwide [ 3 ]. Only in Brazil, the prevalence of cigarette smoking decreased from 15.2% (in 2006) to 9.4% in eight years (in 2014), while the prevalence of abusive alcohol consumption remained stable, even though there was an important increase of this behavior in women [ 4 ].…”

Childhood obesity prevention across borders: A National Institutes of Health commentary

“…The NIH Office of Disease Prevention (ODP) supports this goal and mission by providing leadership for the development, coordination, and implementation of prevention research in collaboration with NIH institutes, centers, and offices and other partners. The ODP puts a high priority on prevention research that addresses the leading risk factors associated with morbidity and mortality (e.g., obesity, poor diet, and physical inactivity) in the United States and other countries 35–37 …”

“…The ODP puts a high priority on prevention research that addresses the leading risk factors associated with morbidity and mortality (e.g., obesity, poor diet, and physical inactivity) in the United States and other countries. [35][36][37] The ODP supports obesity research across the lifespan, examining the causes and consequences of obesity, developing and evaluating new prevention strategies, and determining how to best implement and expand promising interventions. The ODP participates on the NIH Obesity Research Task Force and provides funding for several obesity-related programs and initiatives, including NCCOR.…”