Stressful events throughout the life cycle and social inequalities in a cohort study

Lessa, Ingrid Medeiros; Gonçalves-Silva, Bruna; Menezes, Ana Maria Baptista; Wehrmeister, Fernando César; Gonçalves, Helen

doi:10.1590/0102-311XEN052125

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ARTICLE • Cad. Saúde Pública 41 (11) • 2025 • https://doi.org/10.1590/0102-311XEN052125 linkcopy

Stressful events throughout the life cycle and social inequalities in a cohort study

Eventos estressantes ao longo do ciclo de vida e desigualdades sociais em um estudo de coorte

Eventos estresantes a lo largo del ciclo vital y desigualdades sociales en un estudio de cohorte

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstracts

Stressful events are avoidable and potentially traumatic situations that cause damage to physical and mental health. Research on this topic is generally carried out in contexts without significant social inequalities. We described the prevalence and inequality measures for exposure to different stressful events according to sex, skin color, family income, and schooling using data from five follow-ups of the 1993 Pelotas (Brazil) birth cohort. We evaluated stressful events until adolescence (< 18 years, n = 2,755), in adulthood (18-30 years, n = 1,752), and in both periods (n = 1,400). The characteristics of the analytical samples were approximated to baseline using inverse probability weighting. Simple and complex measures were used to measure inequalities (difference, ratio, SII, and CIX). Until adolescence, the most prevalent stressful events were parental separation (67.5% of men) and the death of a relative (66.1% of women). The death of a relative was the most prevalent stressful event for both sexes in adulthood (men: 65.8%; women: 63.2%) and in both periods (men: 44.1%; women: 44.2%). Regardless of the period of life, black, less educated, and poorer individuals were the most exposed to the majority of stressful events. Emotional neglect, incarceration, parental separation, and discrimination were among the most unequal exposures, with blacks, those with less schooling, and the poorest being most affected, women being more exposed to emotional neglect and discrimination, and men to the other exposures. Physical and mental health care programs should be developed to prevent such exposures and minimize their damage to health, especially in the most vulnerable groups.

Keywords:
Psychological Stress; Socioeconomic Factors; Demography; Social Inequalities; Birth Cohort

Characteristics	Original sample perinatal		Participants included
	Original sample perinatal		Adolescence		Adulthood		Both periods
	%	95%CI	%	95%CI	%	95%CI	%	95%CI
Sex
Male	49.6	48.2; 50.9	49.6	47.7; 51.5	49.6	47.2; 52.0	49.7	47.0; 52.4
Female	50.4	49.0; 51.7	50.4	48.5; 52.3	50.4	48.0; 52.8	50.3	47.6; 53.0
Skin color *
Black	33.5	32.1; 34.9	32.7	30.9; 34.5	34.0	31.8; 36.4	33.2	30.8; 35.8
White	66.5	65.0; 67.9	67.3	65.5; 69.0	66.0	63.6; 68.2	66.7	64.2; 69.8
Family income (minimum wages)
≤ 1	18.8	17.7; 19.9	17.1	15.7; 18.6	17.3	15.6; 19.2	16.6	14.7; 18.7
1.1-3	41.8	40.4; 43.1	41.8	39.9; 43.7	41.8	39.4; 44.1	41.9	39.3; 44.6
3.1-6	23.4	22.3; 24.6	25.7	24.0; 27.4	25.6	23.6; 27.7	25.9	23.6; 28.3
≥ 6.1	15.9	14.9; 16.9	15.4	14.1; 16.9	15.3	13.7; 17.1	15.6	13.7; 17.6
Maternal schooling (years)
0-4	28.0	26.8; 29.2	26.2	24.6; 27.9	27.4	25.3; 29.6	26.9	24.6; 29.4
5-8	46.2	44.9; 47.6	49.2	47.3; 51.0	47.1	44.7; 49.5	47.9	45.3; 50.6
9-11	17.6	16.6; 18.7	17.4	16.0; 18.8	17.9	16.2; 19.8	17.9	15.9; 20.0
12 or more	8.1	7.4; 8.9	7.2	6.3; 8.3	7.6	6.5; 8.9	7.2	6.0; 8.7

Stressful event	Adolescence		Adulthood		Both periods
Stressful event	%	95%CI	%	95%CI	%	95%CI
Physical abuse/violence	56.9	55.0; 58.7	18.1	16.4; 20.1	11.1	9.5; 12.9
Sexual abuse/violence	1.4	1.0; 1.9	3.0	2.3; 3.9	0.1	0.0; 0.6
Emotional neglect	32.6	30.8; 34.4	41.1	38.7; 43.4	17.2	15.3; 19.3
Death of parents	10.0	8.9; 11.2	15.5	13.8; 17.3	1.0	0.6; 1.6
Parental divorce	64.3	62.5; 66.1	8.1	6.9; 9.5	3.9	3.0; 5.1
Death of a relative/close person	64.7	62.8; 66.5	64.5	62.2; 66.7	44.2	41.5; 46.8
Financial difficulties	22.2	20.7; 23.9	39.6	37.3; 42.0	10.9	9.4; 12.7
Discrimination	15.1	13.8; 16.5	30.9	28.7; 33.1	6.2	5.0; 7.6
Domestic violence	28.9	27.2; 30.6	0.7	0.4; 1.2	0.1	0.0; 0.6
Relationship dissolution	20.6	19.1; 22.2	31.4	29.3; 33.7	7.8	6.5; 9.4
Incarceration	4.2	3.5; 5.1	5.0	4.0; 6.2	0.0	-
Moving out against their will	5.9	5.1; 6.9	13.4	11.8; 15.1	1.2	0.7; 1.9
Community fear/insecurity	57.1	55.3; 59.0	58.3	55.9; 60.6	28.0	25.6; 30.5
Mother’s mental disorders	30.0	28.3; 31.8	-	-	-	-

Stressful event	Adolescence
	Sex (male n = 1,341; female n = 1,364)				Skin color (black n = 854; white n = 1,757)
	Difference * (p.p.)	95%CI	Ratio **	95%CI	Difference * (p.p.)	95%CI	Ratio **	95%CI
Physical abuse	6.1	2.0; 10.0	1.1	1.0; 1.2	12.8	8.9; 16.8	1.2	1.2; 1.3
Sexual abuse	-1.7	-2.5; -0.8	0.2	0.1; 0.5	0.5	-0.5; 1.4	1.4	0.7; 2.7
Emotional neglect	-15.1	-19.0; -12.0	0.6	0.5; 0.7	4.9	0.9; 8.7	1.1	1.0; 1.3
Death of parents	-2.0	-4.2; 0.3	0.8	0.6; 1.0	2.9	0.3; 5.4	1.3	1.0; 1.7
Parental divorce	6.3	2.7; 10.0	1.1	1.0; 1.2	12.7	9.0; 16.5	1.2	1.1; 1.3
Death of a relative/close person	-2.9	-6.5; 0.6	0.9	0.9; 1.0	5.7	1.8; 9.6	1.1	1.0; 1.2
Financial difficulties	0.0	-3.1; 3.2	1.0	0.9; 1.1	6.4	2.9; 9.9	1.3	1.1; 1.5
Discrimination	-3.8	-6.5; -1.1	0.8	0.6; 0.9	4.3	1.2; 7.3	1.3	1.1; 1.6
Domestic violence	-5.9	-9.2; -2.4	0.8	0.7; 0.9	7.0	3.1; 10.7	1.3	1.1; 1.4
Relationship dissolution	-4.0	-7.0; -1.0	0.8	0.7; 0.9	-0.3	-3.6; 2.9	1.0	0.8; 1.1
Incarceration	4.1	2.5; 5.6	2.9	1.9; 4.3	1.3	-0.4; 3.0	1.3	0.9; 1.9
Moving out against their will	-3.0	-4.8; -1.2	0.6	0.4; 0.8	1.2	-0.7; 3.1	1.2	0.8; 1.7
Community fear/insecurity	0.7	-2.9; 4.5	1.0	0.9; 1.1	-3.3	-7.3; 0.8	0.9	0.9; 1.0
Mother mental disorders	1.2	-2.2; 4.7	1.0	0.9; 1.2	7.5	3.6; 11.3	1.3	1.1; 1.4
	Adulthood
	Sex (male n = 853; female n = 866)				Skin color (black n = 544; white n = 1,055)
	Difference * (p.p.)	95%CI	Ratio **	95%CI	Difference * (p.p.)	95%CI	Ratio **	95%CI
Physical violence	1.3	-2.4; 4.8	1.1	0.9; 1.3	1.4	-2.6; 5.5	1.1	0.9; 1.3
Sexual violence	-0.8	-2.4; 0.8	0.8	0.4; 1.3	1.3	-0.7; 3.1	1.5	0.8; 2.5
Emotional neglect	-4.9	-9.6; -0.3	0.9	0.8; 1.0	7.6	2.4; 12.7	1.2	1.1; 1.3
Death of parents	-1.2	-4.7; 2.2	0.9	0.7; 1.1	1.3	-2.5; 5.1	1.1	0.8; 7.4
Parental divorce	1.0	-1.6; 3.5	1.1	0.8; 1.5	-1.3	-4.0; 1.5	0.8	0.6; 1.2
Death of a relative/close person	2.6	-2.0; 7.0	1.0	1.0; 1.1	10.0	5.1; 14.7	1.2	1.1; 1.2
Financial difficulties	0.4	-4.2; 5.0	1.0	0.9; 1.1	11.3	6.2; 16.4	1.3	1.2; 1.5
Discrimination	-9.1	-13.5; -4.8	0.7	0.6; 0.8	14.8	9.8; 19.6	1.6	1.4; 1.8
Domestic violence	-0.5	-1.3; 0.2	0.4	0.1; 1.4	0.5	-0.4; 1.5	2.0	0.6; 6.0
Relationship dissolution	2.9	-1.6; 7.2	1.1	0.9; 1.2	6.8	1.9; 11.7	1.2	1.1; 1.4
Incarceration	6.9	5.0; 9.0	5.3	3.0; 9.3	0.7	-1.6; 3.1	1.1	0.7; 1.8
Moving out against their will	0.7	-2.5; 3.9	1.0	0.8; 1.3	2.4	-1.2; 5.9	1.2	0.9; 1.5
Community fear/insecurity	2.0	-2.7; 6.7	1.0	0.9; 1.1	-5.1	-10.3; -0.1	0.9	0.8; 1.0
	Both periods
	Sex (male n = 683; female n = 691)				Skin color (black n = 441; white n = 886)
	Difference * (p.p.)	95%CI	Ratio **	95%CI	Difference * (p.p.)	95%CI	Ratio **	95%CI
Physical abuse/violence	2.3	-1.0; 5.6	1.2	0.9; 1.6	0.8	-2.8; 4.5	1.1	0.8; 1.5
Sexual abuse/violence	0.1	-0.4; 0.4	2.0	0.1; 16.1	0.1	-0.4; 0.6	2.0	0.1; 32.0
Emotional neglect	-6.7	-10.6; -2.7	0.7	0.5; 0.8	6.6	2.1; 11.2	1.4	1.1; 1.8
Death of parents	-0.6	-1.6; 0.5	0.5	0.2; 1.7	0.6	-0.7; 1.8	1.7	0.6; 5.1
Parental divorce	2.6	0.4; 4.5	2,0	1.1; 3.4	1.5	-0.9; 3.8	1.4	0.8; 2.4
Death of a relative/close person	-0.1	-5.3; 5.2	1.0	0.9; 1.1	12.3	6.5; 17.9	1.3	1.1; 1.5
Financial difficulties	0.5	-3.0; 3.7	1.0	0.8; 1.4	5.9	2.0; 9.6	1.6	1.2; 2.2
Discrimination	-3.0	-5.5; -0.4	0.6	0.4; 0.9	5.3	2.3; 8.4	2.3	1.5; 3.5
Domestic violence	0.0	-0.4; 0.4	1.0	0.0; 16.1	0.1	-0.4; 0.6	2.0	0.1; 32.0
Relationship dissolution	0.0	-0.3; 0.3	1.0	0.7; 1.4	2.4	-0.9; 5.5	1.3	0.9; 1.9
Incarceration	0.0	0.0; 0.0	-	-	0.0	0.0; 0.0	-	-
Moving out against their will	-0.3	-1.4; 0.8	0.8	0.3; 2.1	0.3	-0.9; 1.6	1.3	0.5; 3.7
Community fear/insecurity	8.4	3.7; 13.2	1.3	1.1; 1.6	-4.8	-9.8; 0.3	0.8	0.7; 1.0

Stressful event	Adolescence
Stressful event	SII (p.p.)	95%CI	CIX	95%CI	Difference * (p.p.)	95%CI	Ratio **	95%CI
Physical abuse	-22.2	-28.5; -16.0	-0.1	0.0; -0.1	17.2	11.4; 23.1	1.3	1.2; 1.5
Sexual abuse	-2.5	-4.3; -0.7	-0.3	-0.5; -0.1	2.5	0.7; 4.2	4.1	1.5; 13.0
Emotional neglect	-18.6	-24.7; -12.6	-0.1	-0.1; -0.1	17.8	12.1; 23.5	1.7	1.4; 2.0
Death of parents	-12.0	-16.1; -7.9	-0.2	-0.3; -0.1	10.0	6.3; 13.8	2.7	1.9; 4.1
Parental divorce	-46.2	-51.5; -40.8	-0.1	-0.1; -0.1	39.5	34.0; 44.7	1.9	1.7; 2.1
Death of a relative/close person	-9.3	-15.5; -3.1	0.0	0.0; 0.0	9.4	3.8; 15.3	1.1	1.0; 1.3
Financial difficulties	-31.0	-36.2; -25.7	-0.2	-0.3; -0.2	26.9	21.9; 31.9	3.5	2.7; 4.6
Discrimination	-15.8	-20.7; -10.8	-0.2	-0.2; -0.1	12.9	8.2; 17.5	2.1	1.6; 2.7
Domestic violence	-21.1	-26.9; -15.3	-0.1	-0.1; -0.1	18.2	12.8; 23.7	1.9	1.5; 2.3
Relationship dissolution	4.9	-0.4; 10.2	0.0	0.0; 0.1	-4.0	-8.8; 0.9	0.8	0.6; 1.0
Incarceration	-3.9	-7.0; -0.8	-0.2	-0.3; 0.0	3.3	0.5; 6.3	1.7	1.1; 2.9
Moving out against their will	-9.1	-12.7; -5.6	-0.2	-0.3; -0.2	7.3	3.9; 10.4	2.9	1.7; 4.5
Community fear/insecurity	0.5	-6.0; 7.0	0.0	0.0; 0.0	-2.2	-8.2; 3.7	1.0	0.9; 1.1
Mother mental disorders	-27.5	-33.3; -21.8	-0.1	-0.2; -0.1	24.0	18.5; 29.5	2.2	1.8; 2.6
	Adulthood
	SII (p.p.)	95%CI	CIX	95%CI	Difference * (p.p.)	95%CI	Ratio **	95%CI
Physical violence	-13.2	-20.4; -5.9	-0.1	-0.1; 0.0	8.4	1.7; 15.1	1.5	1.1; 2.1
Sexual violence	-3.0	-6.5; 0.4	0.0	-0.2; 0.1	2.8	-0.5; 6.0	2.2	0.9; 5.2
Emotional neglect	-17.0	-25.8; -8.2	0.0	-0.1; 0.0	14.7	6.4; 22.7	1.4	1.2; 1.7
Death of parents	-14.6	-21.1; -8.1	-0.1	-0.2; 0.0	12.7	6.7; 18.4	2.5	1.6; 3.9
Parental divorce	- 0.8	-5.9; 4.2	0.0	-0.1; 0.1	4.0	-0.8; 8.4	1.6	0.9; 2.8
Death of a relative/close person	-11.9	-20.6; -3.2	0.0	0.0; 0.0	8.4	0.4; 16.4	1.1	1.0; 1.3
Financial difficulties	-21.4	-30.0; -12.8	0.0	-0.1; 0.0	23.0	15.2; 31.0	1.9	1.5; 2.3
Discrimination	-8.7	-17.0; -0.5	0.0	0.0; 0.0	10.1	2.7; 17.8	1.4	1.1; 1.9
Domestic violence	-2.0	-4.0; -0.1	-0.4	-0.7; 0.0	1.9	0.0; 3.8	7.3	0.8; 52.5
Relationship dissolution	-12.5	-21.1; -4.0	0.0	-0.1; 0.0	9.0	0.9; 16.7	1.3	1.0; 1.6
Incarceration	-7.4	-11.5; -3.3	-0.1	-0.2; 0.1	6.1	2.7; 9.4	6.5	2.0; 22.4
Moving out against their will	-10.9	-17.1; -4.7	0.0	-0.1; 0.0	9.0	3.5; 14.7	2.0	1.3; 3.3
Community fear/insecurity	-3.5	-5.5; 12.5	0.0	0.0; 0.0	-3.2	-11.6; 5.0	0.9	0.8; 1.1
	Both periods
	SII (p.p.)	95%CI	CIX	95%CI	Difference * (p.p.)	95%CI	Ratio **	95%CI
Physical abuse/violence	-10.3	-16.7; -3.9	0.0	-0.1; 0.0	7.8	2.0; 13.7	2.2	1.2; 4.0
Sexual abuse/violence	0.0	-1.7; 0.5	-0.2	-1.3; 0.9	0.6	-0.5; 1.5	-	-
Emotional neglect	-17.0	-24.7; -9.3	-0.1	-0.1; 0.0	15.2	7.9; 22.6	2.4	1.6; 3.7
Death of parents	0.7	-0.7; 2.2	0.2	0.0; 0.4	-0.1	-1.2; 1.4	0.8	0.1; 18.7
Parental divorce	-2.4	-6.2; 1.4	0.0	-0.2; 0.2	3.2	-0.1; 6.9	3.0	0.9; 9.3
Death of a relative/close person	-17.0	-26.9; -7.1	0.0	0.0; 0.0	12.3	3.1; 21.6	1.4	1.1; 1.7
Financial difficulties	-13.4	-19.6; -7.2	0.0	-0.1; 0.1	12.8	7.1; 18.5	4.6	2.2; 10.0
Discrimination	-4.7	-9.9; 0.5	-0.1	-0.2; 0.0	3.8	-0.8; 8.7	1.8	0.9; 3.8
Domestic violence	-0.9	-2.1; 0.3	-0.9	-1.0; -0.7	1,0	-0.3; 2.4	-	-
Relationship dissolution	-5.4	-11.0; 0.2	-0.1	-0.2; 0.0	3.0	-2.0; 8.2	1.5	0.8; 3.0
Incarceration	-	0.0	0.0	-	-	-	-	-
Moving out against their will	-2.8	-5.1; -0.5	-0.1	-0.5; 0.3	2.1	0.1; 4.0	-	-
Community fear/insecurity	1.7	-7.7; 11.1	0.0	-0.1; 0.0	-3.5	-12.1; 5.0	0.9	0.6; 1.2

Stressful event	Adolescence
Stressful event	SII (p.p.)	95%CI	CIX	95%CI	Difference * (p.p.)	95%CI	Ratio **	95%CI
Physical abuse	-38.7	-45.1; -32.3	-0.1	-0.1; -0.1	28.1	18.2; 38.4	1.7	1.3; 2.2
Sexual abuse	-2.1	-4.0; -0.1	-0.2	-0.4; 0.0	-0.3	-3.0; 3.0	0.9	0.2; 4.1
Emotional neglect	-6.7	-13.5; 0.1	0.0	-0.1; 0.0	5.6	-3.8; 15.0	1.2	0.9; 1.6
Death of parents	-11.7	-16.3; -7.1	-0.2	-0.2; -0.1	6.3	0.7; 11.8	1.9	0.9; 3.9
Parental divorce	-46.7	-52.6; -40.9	-0.1	-0.1; -0.1	41.2	31.1; 50.9	2.1	1.6; 2.7
Death of a relative/close person	-11.8	-18.8; -4.9	0.0	0.0; 0.0	5.4	-4.5; 15.4	1.1	0.9; 1.3
Financial difficulties	-29.9	-35.7; -24.0	-0.2	-0.2; -0.1	19.4	13.0; 26.7	2.6	1.6; 4.8
Discrimination	-11.9	-17.2; -6.6	-0.1	-0.2; -0.1	6.6	-0.4; 13.3	1.5	0.9; 2.6
Domestic violence	-13.6	-20.2; -7.0	-0.1	-0.1; 0.0	6.7	-2.7; 15.6	1.2	0.9; 1.7
Relationship dissolution	-1.7	-7.7; 4.2	0.0	-0.1; 0.0	-2.9	-11.1; 6.4	0.9	0.6; 1.3
Incarceration	-9.8	-13.6; -6.0	-0.3	-0.4; -0.2	2.7	-1.2; 7.2	1.6	0.6; 4.6
Moving out against their will	-7.8	-11.5; -4.1	-0.2	-0.2; -0.1	4.1	-0.1; 8.3	2.0	0.7; 5.3
Community fear/insecurity	3.5	-3.7; 10.8	0.0	0.0; 0.0	-3.8	-13.8; 6.5	0.9	0.8; 1.1
Mother mental disorders	-31.0	-37.3; -24.7	-0.1	-0.2; -0.1	16.8	8.0; 25.6	1.7	1.2; 2.5
	Adulthood
	SII (p.p.)	95%CI	CIX	95%CI	Difference * (p.p.)	95%CI	Ratio **	95%CI
Physical violence	-3.7	-10.7; 3.3	0.0	-0.1; 0.0	5.2	0.0; 10.6	1.3	1.0; 1.6
Sexual violence	-2.7	-6.1; 0.7	-0.1	-0.3; 0.1	3.3	0.6; 6.2	2.2	1.2; 4.1
Emotional neglect	1.0	-7.7; 9.7	0.0	0.0; 0.0	0.6	-5.8; 7.0	1.0	0.9; 1.2
Death of parents	-10.8	-17.1; -4.4	-0.1	-0.2; 0.0	7.9	2.9; 12.8	1.6	1.2; 2.2
Parental divorce	-2.5	-7.4; 2.4	0.0	-0.1; 0.1	2.2	-1.4; 6.0	1.3	0.9; 2.0
Death of a relative/close person	-7.0	-15.5; 1.5	0.0	0.0; 0.0	3.6	-2.6; 9.8	1.1	1.0; 1.2
Financial difficulties	-12.5	-21.0; -4.0	0.0	-0.1; 0.0	8.1	1.7; 14.4	1.2	1.0; 1.4
Discrimination	14.4	6.2; 22.6	0.1	0.0; 0.1	-7.8	-13.7; 1.9	0.8	0.6; 0.9
Domestic violence	-0.6	-2.0; 0.7	-0.2	-0.5; 0.1	0.4	-0.7; 1.5	1.8	0.4; 7.9
Relationship dissolution	-2.0	-10.4; 6.2	0.0	0.0; 0.0	3.7	-2.4; 9.9	1.1	0.9; 1.3
Incarceration	-11.5	-16.1; -7.0	-0.3	-0.4; -0.2	8.6	5.1; 12.1	5.1	2.9; 9.2
Moving out against their will	-6.8	-13.1; -0.5	-0.1	-0.1; 0.0	7.1	2.2; 12.0	1.6	1.2; 2.1
Community fear/insecurity	20.2	11.8; 28.6	0.0	0.0; 0.1	-15.5	-21.9; -9.1	0.7	0.6; 0.8
	Both periods
	SII (p.p.)	95%CI	CIX	95%CI	Difference * (p.p.)	95%CI	Ratio **	95%CI
Physical abuse/violence	-10.4	-17.0; -3.8	-0.1	-0.2; 0.0	9.6	4.2; 14.8	2.1	1.4; 2.9
Sexual abuse/violence	-0.8	-2.0; 0.4	-0.8	-0.9; -0.7	0.8	-0.3; 1.9	-	-
Emotional neglect	-4.4	-12.0; 3.0	0.0	-0.1; 0.0	4.5	-1.1; 10.4	1.3	0.9; 1.7
Death of parents	-1.6	-3.6; 0.4	-0.4	-0.6; 0.0	1.0	-0.5; 2.7	3.0	0.7; 14.4
Parental divorce	-6.6	-10.6; -2.5	-0.2	-0.4; 0.0	4.3	1.2; 7.5	3.3	1.6; 6.8
Death of a relative/close person	-11.4	-21.1; -1.7	0.0	-0.1; 0.0	8.0	0.7; 15.2	1.2	1.0; 1.4
Financial difficulties	-10.7	-16.8; -4.6	-0.1	-0.2; 0.0	7.1	2.3; 12.0	1.9	1.3; 2.9
Discrimination	0.2	-4.7; 5.0	0.0	-0.1; 0.1	0.5	-3.2; 4.2	1.1	0.6; 1.8
Domestic violence	-0.5	-1.3; 0.3	-0.6	-0.8; -0.5	0.4	-0.4; 1.1	-	-
Relationship dissolution	-4.5	-10.1; 1.0	-0.1	-0.2; 0.0	4.0	-0.2; 8.4	1.6	1.0; 2.5
Incarceration	0.0	-	-	-	0.0	0.0; 0.0	-	-
Moving out against their will	-3.1	-6.0; -0.3	-0.4	-0.7; 0.0	3.1	0.5; 5.2	5.4	1.7; 17.7
Community fear/insecurity	12.4	3.5; 21.3	0.1	0.0; 0.1	-8.9	-15.3; -2.7	0.7	0.5; 0.9

Characteristics	Adolescence
	0		1-2		3 or more
	%	95%CI	%	95%CI	%	95%CI
Sex
Male	1.5	1.0; 2.4	21.2	19.0; 23.6	77.2	74.8; 79.5
Female	1.5	1.0; 2.3	22.0	20.0; 24.2	76.4	74.2; 78.5
Skin color
Black	1.5	0.9; 2.6	14.8	12.6; 17.3	83.7	81.1; 86.0
White	1.6	1.1; 2.3	24.9	22.9; 27.0	73.5	71.4; 75.6
Family income (quintiles)
1st (poorest)	0.4	0.1; 1.7	11.8	9.2; 14.9	87.8	84.6; 90.4
2nd	0.9	0.4; 2.2	15.0	12.2; 18.3	84.1	80.7; 87.0
3rd	1.4	0.7; 2.8	20.5	17.4; 24.0	78.1	74.5; 81.3
4th	2.0	1.1; 3.6	26.8	23.2; 30.6	71.2	67.3; 74.9
5th (wealthy)	2.8	1.7; 4.6	33.0	29.1; 37.1	64.2	60.0; 68.2
Schooling (years)
0-8	0.8	0.4; 1.5	11.7	9.9; 13.7	87.5	85.5; 89.4
9-11	2.2	1.6; 3.1	29.0	26.7; 31.4	68.8	66.3; 71.1
12 or more	0.8	0.1; 5.7	35.2	26.4; 45.2	63.9	54.0; 72.8
	Adulthood
	0		1-2		3 or more
	%	95%CI	%	95%CI	%	95%CI
Sex
Male	4.8	3.5; 6.6	32.8	29.6; 36.3	62.3	58.8; 65.7
Female	4.9	3.7; 6.4	33.0	30.1; 36.1	62.1	58.9; 65.1
Skin color
Black	3.9	2.5; 5.8	27.6	24.0; 31.5	68.5	64.6; 72.3
White	5.2	4.0; 6.8	36.3	33.4; 39.3	58.5	55.4; 61.4
Family income (quintiles)
1st (poorest)	3.9	2.2; 6.9	26.1	21.2; 31.8	70.0	64.2; 75.2
2nd	4.0	2.2; 7.2	31.1	25.8; 37.0	64.9	58.9; 70.4
3rd	6.3	3.9; 10.0	31.4	26.2; 37.1	62.3	56.4; 67.8
4th	2.7	1.4; 5.4	37.6	32.1; 43.4	59.7	53.9; 65.2
5th (wealthy)	7.0	4.5; 10.6	42.4	36.7; 48.2	50.6	44.8; 56.4
Schooling (years)
0-8	6.3	4.0; 9.6	30.8	25.9; 36.2	63.0	57.4; 68.2
9-11	5.9	4.3; 8.1	32.7	29.0; 36.6	61.4	57.4; 65.3
12 or more	3.4	2.3; 4.9	34.4	31.1; 37.8	62.2	58.8; 65.6
	Both periods
	0		1-2		3 or more
	%	95%CI	%	95%CI	%	95%CI
Sex
Male	26.9	23.4; 30.6	57.5	53.5; 61.4	15.6	12.9; 18.8
Female	27.7	24.6; 31.0	57.0	53.5; 60.5	15.3	12.9; 18.0
Skin color
Black	22.7	19.1; 26.7	57.0	52.4; 61.4	20.3	16.9; 24.3
White	29.9	26.9; 33.1	56.6	53.2; 59.9	13.5	11.4; 16.0
Family income (quintiles)
1st (poorest)	20.7	15.7; 26.9	58.5	51.5; 65.2	20.7	15.6; 26.9
2nd	24.6	19.3; 30.8	56.8	50.1; 63.3	18.6	13.9; 24.4
3rd	25.0	19.8; 31.0	61.7	55.2; 67.8	13.3	9.5; 18.4
4th	32.2	26.4; 38.6	56.7	50.2; 63.1	11.0	7.5; 15.9
5th (wealthy)	34.8	28.8; 41.2	57.2	50.7; 63.5	8.0	5.1; 12.4
Schooling (years)
0-8	27.5	22.2; 33.6	48.6	42.4; 55.0	23.8	18.9; 29.6
9-11	26.2	22.4; 30.3	58.8	54.3; 63.1	15.1	12.1; 18.5
12 or more	28.1	24.7; 31.8	59.5	55.6; 63.3	12.3	9.9; 15.2

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Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Rua Leopoldo Bulhões, 1480 , 21041-210 Rio de Janeiro RJ Brazil, Tel.:+55 21 2598-2511, Fax: +55 21 2598-2737 / +55 21 2598-2514 - Rio de Janeiro - RJ - Brazil
E-mail: cadernos@ensp.fiocruz.br

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[TFN1] 95%CI: 95% confidence interval.

[TFN2] * Variable with the highest number of missing (n = 4,164).