Biopsychosocial inequality, active lifestyle and chronic health conditions: a cross-sectional National Health Survey 2013 in Brazil

Abstract

This study estimated the biopsychosocial factors related to active physical behavior in the Brazilian population with and without chronic non-transmissible disease (NCD). Cross-sectional study of the National Health Survey (NHS) in Brazil, with 60,202 individuals in 2013. Participants were randomly selected by complex sampling. The outcome was physically active behavior measured by performing a minimum of 150 min of physical exercise per week. The independent variables were social and psychological characteristics, lifestyle and health. Cox regression was applied to estimate the prevalence ratio (PR). There are 29,666 (48.3%; 95% CI 47.0–50.0) participants reported having NCD. Not being a smoker or alcoholic, living in an urban area (PR = 1.44; CI95% 1.23–1.68/PR = 1.38; CI95% 1.08–1.75), having informal social support (PR = 1.26; CI95% 1.10–1.44/PR = 1.19; CI95% 1.05–1.34), A social class (PR = 0.43; CI95% 0.25–0.73/PR = 0.46; CI95% 0.26–0.80), high schooling (PR = 0.34; CI95% 0.23–0.51/PR = 0.33; CI95% 0.24–0.46) as well as paid work (PR = 0.87; CI95% 0.78–0.96/PR = 0.89; CI95% 0.79–0.99) are more associated with active lifestyle in both groups. However, only in the group without NCD, the male sex (PR = 1.42; CI95% 1.28–1.57), no having some disability (PR = 1.31; CI95% 1.03–1.66) and having private health insurance (PR = 1.26; CI95% 1.13–1.41) were more associated with active behavior, while in the group with NCD, being elderly (PR = 1.22; CI95% 1.05–1.42), not be white (PR = 0.85; CI95% 0.77–0.95) and not having restful sleep (PR = 1.23; CI95% 1.08–1.40) are associated with active lifestyle. People with and without NCD in Brazil have very close active behavior, however, some biopsychosocial factors such as: sex, age, lifestyle, socioeconomic level are unevenly associated with the active lifestyle in the groups. Thus, therapeutic or preventive proposals as well as public policies for health promotion must observe these distinctions when elaborating their actions.

Differential Factors Are Associated with Physical Activity in Older Adults in Brazil with and without Non-Communicable Chronic Diseases: A Cross-Sectional Analysis of the 2019 National Health Survey

“…Regarding being male and having a higher chance of being physically active in the group without NCD, similar results were found by Guedes et al (2021) [20]. The literature has shown gender inequality in physical activity [18,28].…”

“…Having a high level of education and a high per capita income are significant factors for engaging in physical activity in leisure time. Guedes et al (2021) [20] showed similar results, making it possible to analyze that the realization and encouragement of leisure-time physical activities have a higher frequency among people with higher education levels, which generates a better understanding of the importance of staying physically active, such as the necessary health care, leading these individuals to use the health system more frequently [36].…”

“…The fact that we divided the sample into individuals with and without NCD in our study may explain this result, in addition to considering only older adults herein. In other studies, the sample was not divided into two groups or was not analyzed by Brazilian regions [20,35].…”

“…The differences observed in the literature [15,19,20] indicate that the older adults population still presents low levels of physical activity due to aging [11], which can create greater barriers for people living with NCD. Considering that these factors may remain interconnected with social inequality seen in different regions of Brazil [21], as well as access to healthcare services [19] and differences in race, education, and economic level, show significant relationships with the presence or worsening of NCD [18], causing difficulties for physical activity practice in these individuals, in addition to the limitations already present due to NCD.…”

“…Considering this, we suggest that this study can provide more reliable and updated data regarding these associations, especially considering the representative size of the national sample and the specific group studied. Therefore, it is necessary to understand factors that implicate physical activity practice [16], such as NCD in the older adults population [22], given that until now, what is known is that studies have sought to investigate certain factors in groups of people living with NCD in different populations [20]. This led our study to analyze sociodemographic factors, health perception, dietary habits, and screen time as related or not to physical activity practice in older Brazilian individuals with and without NCD through the National Health Survey (NHS) of 2019.…”