Associations between noncommunicable disease risk factors, race, education, and health insurance status among women of reproductive age in Brazil - 2011

• Type of Material: Article
• Authors: Jonetta Johnson Mpofu, Centers for Disease Control and Prevention; Lenildo de Moura de Moura, Pan-Americana Health Organization; Sherry L. Farr, Centers for Disease Control and Prevention; Deborah Carvalho Malta, Ministry of Health of Brazil; Betine Moehlecke Iser, Ministry of Health of Brazil; Regina Tomie Ivata Bernal, Ministry of Health of Brazil; Cheryl L. Robbins, Centers for Disease Control and Prevention; Felipe Lobelo, Emory University
• Language: English
• Date: 2016-04-07
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2016.Published by Elsevier Inc.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.pmedr.2016.03.015
• Title of Journal or Parent Work: Preventive Medicine Reports
• ISSN: 2211-3355
• Volume: 3
• Start Page: 333
• End Page: 337
• Grant/Funding Information: U.S. Centers for Disease Control and Prevention.
• Keywords: Risk factors; Health; Insurance; Reproductive health; Education; Chronic disease; Women
• Research Categories: Health Sciences, Public Health; Health Sciences, Education

Abstract

Background: Noncommunicable disease (NCD) risk factors increase the risk of adverse reproductive health outcomes and are becoming increasingly common in Brazil. Methods: We analyzed VIGITEL 2011 telephone survey data for 13,745 Brazilian women aged 18-44 years in a probabilistic sample from 26 Brazilian state capitals and the Federal District. We examined associations between NCD risk factors (fruit and vegetable intake, leisure time physical activity, alcohol consumption, smoking status, BMI and hypertension status) and race, education, and insurance using chi-square tests and multivariable logistic regression models, estimating the average marginal effects to produce adjusted relative risk ratios (aRRs). Analyses were conducted using SAS 9.3 survey procedures and weighted to reflect population estimates. Results: Women with less than a college education were more likely to report physical inactivity (adjusted relative risk (aRR) and 95% confidence interval = 1.1 (1.1-1.2)), smoking (aRR = 1.7 (1.3-2.2)), and self-reported diagnoses of hypertension (aRR = 2.0 (1.6-2.5)) compared to women with a college education or greater. Similarly, women without health insurance were more likely to report physical inactivity (aRR = 1.1 (1.1-1.2)), smoking (aRR = 1.4 (1.1-1.8)), and self-reported diagnoses of hypertension aRR = 1.4 (1.1-1.7)) compared to women with health insurance. Less variation was found by race and NCD risk factors. Conclusion: Targeted public health strategies and policies are needed to increase healthcare access and decrease educational and racial disparities in NCD risk factors among women of reproductive age in Brazil.