Characteristics associated to a poor self-rated health in Brazilian adolescents, National Adolescent School-based Health Survey, 2015

Malta, Deborah Carvalho; Oliveira, Max Moura de; Machado, Isis Eloah; Prado, Rogério Ruscito; Stopa, Sheila Rizzato; Crespo, Claudio Dutra; Assunção, Ada Ávila

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Revista Brasileira de Epidemiologia

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ORIGINAL ARTICLE • Rev. bras. epidemiol. 21 (suppl 1) • 2018 • https://doi.org/10.1590/1980-549720180018.supl.1 copy

Characteristics associated to a poor self-rated health in Brazilian adolescents, National Adolescent School-based Health Survey, 2015

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT:

Introduction:

Health self-assessment (HSA) is a widely studied indicator among adults and the elderly, but not often explored in adolescents. This study aimed to estimate the prevalence of poor self-rated health in Brazilian schoolchildren and associated factors.

Methods:

Data from the 2015 National Adolescent School-based Health Survey (PeNSE) were analyzed; prevalences and their 95% confidence intervals (95%CI) were estimated for poor self-rated health and associated factors. Multiple logistic regression analysis was performed.

Results:

A total of 7.1% (95%CI 7.0 - 7.3) of the schoolchildren reported a poor self-assessed health status. Sociodemographic characteristics, such as female gender, 15 years of age or older, yellow, brown and indigenous race/skin color; risk behaviors such as regular alcohol consumption and drug experimentation, and issues related to physical and emotional health remained positively associated with the outcome studied. Protective factors identified were maternal schooling and demand for health services.

Conclusion:

The impact of risky behaviors on physical and emotional health need to be addressed among students. The school presents itself as a safe and opportune space for promoting a healthy lifestyle.

Keywords:
Adolescent; Self-Assessment; Health status; Health surveys

Variable	Poor or very poor assessment of health status										p-value
	%	95%CI		OR _unadjusted	95%CI		p-value	OR _unadjusted	95%CI
	%	Bottom	Higher	OR _unadjusted	Bottom	Higher	p-value	OR _unadjusted	Bottom	Higher
Total	7.1	7.0	7.3
Age in years < 13	6.5	4.4	9.4	1.07	0.72	1.61	0.731	1.24	0.80	1.91	0.339
13	6.1	5.6	6.6	1.00				1.00
14	6.5	6.0	6.9	1.07	1.00	1.15	0.063	0.97	0.90	1.05	0.483
15	8.3	7.7	9.0	1.41	1.30	1.53	< 0.001	1.16	1.06	1.28	0.002
16 or more	9.8	9.2	10.4	1.68	1.54	1.84	< 0.001	1.32	1.18	1.48	< 0.001
Gender
Male	6.5	6.2	6.8	1.00				1.00
Female	7.7	7.5	8.0	1.21	1.15	1.27	< 0.001	1.12	1.06	1.20	< 0.001
Race/Skin color
White	6.8	6.1	7.6	1.00				1.00
Black	7.1	6.3	8.1	1.05	0.97	1.14	0.198	1.01	0.92	1.11	0.883
Yellow	8.9	7.7	10.2	1.34	1.19	1.50	< 0.001	1.44	1.26	1.64	< 0.001
Brown	7.0	6.3	7.9	1.04	0.98	1.10	0.173	1.11	1.04	1.19	0.001
Indigenous	9.6	8.7	10.7	1.46	1.29	1.65	< 0.001	1.44	1.25	1.67	< 0.001
School type
Private	7.2	6.8	7.7	1.00
Public	6.6	6.2	7.0	0.90	0.84	0.97	0.005
Currently working
No	6.9	6.5	7.3	1.00
Yes	8.7	8.3	9.2	1.30	1.22	1.39	< 0.001
Maternal schooling
No schooling	9.6	8.7	10.6	1.00				1.00
Primary (incomplete/complete)	7.4	6.9	7.9	0.75	0.68	0.83	< 0.001	0.82	0.74	0.91	< 0.001
Secondary (incomplete/complete)	7.2	6.7	7.7	0.73	0.66	0.81	< 0.001	0.80	0.71	0.89	< 0.001
Higher (incomplete/complete)	6.7	6.3	7.1	0.67	0.61	0.75	< 0.001	0.72	0.65	0.81	< 0.001
Living with mother and/or father
No	9.5	8.8	10.4	1.00
Yes	7.0	6.8	7.1	0.71	0.65	0.78	< 0.001
Eats breakfast regularly
No	8.6	8.2	8.9	1.00
Yes	6.3	6.1	6.5	0.72	0.69	0.76	< 0.001
Has meals with their guardian
No	14.2	13.2	15.2	2.41	2.23	2.61	< 0.001	1.76	1.59	1.94	< 0.001
Twice a week or less	8.0	7.5	8.4	1.26	1.19	1.34	< 0.001	0.99	0.91	1.07	0.736
3 to 4 times a week	6.8	6.0	7.7	1.07	0.94	1.23	0.303	0.91	0.78	1.06	0.207
5 or more times a week	6.4	6.2	6.6	1.00				1.00
Regular tobacco use
No	6.8	6.3	7.3	1.00
Yes	12.8	11.9	13.7	2.01	1.85	2.18	< 0.001
Regular alcohol use
No	6.4	6.1	6.7	1.00				1.00
Yes	9.5	9.1	9.9	1.54	1.46	1.62	< 0.001	1.08	1.00	1.15	0.038
Drug experimentation
No	6.7	6.2	7.1	1.00				1.00
Yes	11.8	11.2	12.5	1.89	1.76	2.02	< 0.001	1.14	1.04	1.25	0.007
Body image
Thin	7.0	6.6	7.5	1.00				1.00
Normal	6.0	5.7	6.4	0.85	0.80	0.90	< 0.001	0.94	0.88	1.01	0.073
Fat	10.5	10.1	11.0	1.56	1.46	1.67	< 0.001	1.42	1.31	1.54	< 0.001
Soft drink consumption (> 5 times a week)
No	6.6	6.3	6.9	1.00				1.00
Yes	8.5	8.2	8.8	1.31	1.25	1.38	< 0.001	1.19	1.12	1.26	< 0.001
Frequent fruit consumption (> 5 times a week)
No	7.2	6.9	7.5	1.00
Yes	6.9	6.7	7.2	0.97	0.92	1.02	0.174
Regular physical activity
No	7.0	6.7	7.4	1.00				1.00
Yes	7.4	7.0	7.8	1.05	0.99	1.12	0.091	1.14	1.06	1.22	< 0.001
Feeling lonely
No	6.0	5.7	6.3	1.00				1.00
Yes	12.9	12.4	13.4	2.32	2.20	2.45	< 0.001	1.51	1.40	1.62	< 0.001
Insomnia
No	6.2	5.8	6.5	1.00				1.00
Yes	14.4	13.7	15.0	2.54	2.40	2.70	< 0.001	1.55	1.43	1.68	< 0.001
Friends
1 or more	6.9	6.3	7.6	1.00				1.00
None	10.9	10.0	11.9	1.65	1.50	1.82	< 0.001	1.38	1.22	1.55	< 0.001
Sexual intercourse
No	6.1	5.9	6.4	1.00				1.00
Yes	9.7	9.3	10.0	1.63	1.55	1.72	< 0.001	1.29	1.20	1.38	< 0.001
Asthma
No	6.6	6.3	7.0	1.00				1.00
Yes	9.6	9.2	10.1	1.51	1.42	1.60	< 0.001	1.30	1.21	1.39	< 0.001
Demand for any health services
No	7.2	6.9	7.5	1.00				1.00
Yes	7.0	6.8	7.2	0.97	0.92	1.02	0.200	0.83	0.78	0.88	< 0.001
Missed classes for health reasons
Não	5.6	5.3	6.0	1.00				1.00
1 to 3 days	6.7	6.4	7.1	1.21	1.15	1.29	< 0.001	1.28	1.20	1.38	< 0.001
4 or more	11.8	11.3	12.2	2.24	2.11	2.38	< 0.001	2.15	1.99	2.32	< 0.001

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[1] Corresponding author: Deborah de Carvalho Malta. Avenida Alfredo Balena, 190, Santa Efigênia, CEP: 30130-100, Belo Horizonte, MG, Brasil. E-mail: dcmalta@uol.com.br