2019 National Health Survey: sustainability and continuity of health surveillance of the Brazilian population

Deborah Carvalho Malta Célia Landmann Szwarcwald Sheila Rizzato Stopa Eduardo Luiz Gonçalves Rios NetoAbout the authors

In this supplement, the Revista Brasileira de Epidemiologia (RBE) presents articles based on unpublished results of the second edition of the National Health Survey (Pesquisa Nacional de Saúde) — the 2019 PNS. Health research and surveys produce knowledge that can be used to improve the performance of the health system, the health of individuals and populations, and reduce health inequalities11. Barros, MBA. Inquéritos domiciliares de saúde: potencialidades e desafios. Rev Bras Epidemiol 2008; 11 (Suppl 1): 6-19. https://doi.org/10.1590/S1415-790X2008000500002
https://doi.org/10.1590/S1415-790X200800...
,22. Malta DC, Leal MC, Costa MFL, Morais Neto OL. Inquéritos Nacionais de Saúde: experiência acumulada e proposta para o inquérito de saúde brasileiro. Rev Bras Epidemiol 2008; 11 (Suppl 1): 159-167. https://doi.org/10.1590/S1415-790X2008000500017
https://doi.org/10.1590/S1415-790X200800...
.

Public health policies should be grounded in objective information backed by scientific evidence. Public Health and Epidemiology play a key role in this process, either through the development of research or through the systematic data collection from information and surveillance systems, enabling the systematic evaluation of data on the magnitude, scope, characteristics, and consequences of diseases. Health surveys produce information that can make public managers responsible for implementing public policies aware of the main issues and inequities experienced by the population22. Malta DC, Leal MC, Costa MFL, Morais Neto OL. Inquéritos Nacionais de Saúde: experiência acumulada e proposta para o inquérito de saúde brasileiro. Rev Bras Epidemiol 2008; 11 (Suppl 1): 159-167. https://doi.org/10.1590/S1415-790X2008000500017
https://doi.org/10.1590/S1415-790X200800...
.

PNS is a population-based survey representative of Brazil and its population living in private households, carried out by the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística — IBGE) in partnership with the Ministry of Health and in collaboration with education and research institutions. Its first edition (2013) covered more than 64,000 households and included topics such as access to services (continuing the investigation on the theme of the Health Appendices of 1998, 2003, and 2008 editions of the National Household Sample Survey — Pesquisa Nacional por Amostra de Domicílios, PNAD), private health insurance, primary care, chronic non-communicable diseases (NCDs) and their risk and protective factors, and physical measurements (anthropometric and blood pressure). In addition, the 2013 PNS also collected biological material for laboratory tests, an important advancement in population-based research from the public health system (Sistema Único de Saúde — SUS). The 2019 PNS expanded its sample to over 94,000 households, representing the second instance of this important survey and allowing the comparison and evaluation of changes in the health of the country’s population. In 2019, the survey included the population aged 15 years and older, as well as new health-relevant issues. Anthropometric data were obtained from a subsample, but no laboratory and blood pressure measurements were taken33. Instituto Brasileiro de Geografia e Estatística. Pesquisa nacional de saúde: 2019: percepção do estado de saúde, estilos de vida, doenças crônicas e saúde bucal: Brasil e grandes regiões. IBGE, Coordenação de Trabalho e Rendimento. Rio de Janeiro: IBGE; 2020. 113p..

The PNS analysis provides information and establishes consistent measures on health determinants, conditions, and needs of the Brazilian population. It also offers estimates based on the urban/rural situation, major regions, states and the Federal District, capital municipalities, and metropolitan areas, allowing us to know the actual access to health services and the living and health conditions of the country’s population.

PNS is a valuable tool to support the SUS health planning and elaborate integrated and coordinated social public policies. As a future challenge, PNS is expected to advance to correlations and linkages, such as health information systems related to mortality, hospital, and other associated data, allowing us to produce and test new hypotheses. Moreover, proposals have been made to proceed with a baseline for longitudinal studies based on PNS, allowing the follow-up of future health outcomes and advancements in estimating disease incidence.

This supplement represents the partnership between different education and research institutions of the country, which have joined to analyze this important database, involving countless themes that cover different dimensions of the health status of the Brazilian population. The analyses involved NCDs and their risk factors, lifestyles, multimorbidity, older adult health, anthropometric measurements, violence, intimate partner violence, access to and use of services, preventive actions, and continuity of care, considering the associations between health indicators and demographic and socioeconomic factors. The themes presented herein are very relevant and invaluable for the evaluation of SUS.

The results reported in this supplement also make it possible not only to know the health status of the Brazilian population and the changes that occurred between 2013 and 2019 but also to monitor the national and global goals for the control and prevention of NCDs, as well as the Sustainable Development Goals (SDGs)44. United Nations. Transforming our world: the 2030 agenda for sustainable development. general assembly; 2015. [accessed on Aug. 15, 2021]. Available at: https://www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1⟪=E
https://www.un.org/ga/search/view_doc.as...
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PNS is a milestone for Brazilian public health, especially when taking into account the context of economic and political crises, in addition to the austerity measures that put at risk the continuity of public policies and epidemiological surveys. Therefore, investing in the sustainability and quality of health information systems, as well as conducting regular surveys such as PNS, provides sustainability for and strengthens health surveillance55. Malta DC, Duncan BB, Schmidt MI, Teixeira R, Ribeiro ALP, Felisbino-Mendes MS, et al. Trends in mortality due to non-communicable diseases in the Brazilian adult population: national and subnational estimates and projections for 2030. Popul Health Metr 2020; 18 (Suppl 1): 16. https://doi.org/10.1186/s12963-020-00216-1
https://doi.org/10.1186/s12963-020-00216...
. Thus, we expect that the analyses presented in this supplement can produce knowledge for scientific growth and that their results contribute to support health managers and professionals and society in general in the guidance of public health policies.

REFERENCES

  • 1.
    Barros, MBA. Inquéritos domiciliares de saúde: potencialidades e desafios. Rev Bras Epidemiol 2008; 11 (Suppl 1): 6-19. https://doi.org/10.1590/S1415-790X2008000500002
    » https://doi.org/10.1590/S1415-790X2008000500002
  • 2.
    Malta DC, Leal MC, Costa MFL, Morais Neto OL. Inquéritos Nacionais de Saúde: experiência acumulada e proposta para o inquérito de saúde brasileiro. Rev Bras Epidemiol 2008; 11 (Suppl 1): 159-167. https://doi.org/10.1590/S1415-790X2008000500017
    » https://doi.org/10.1590/S1415-790X2008000500017
  • 3.
    Instituto Brasileiro de Geografia e Estatística. Pesquisa nacional de saúde: 2019: percepção do estado de saúde, estilos de vida, doenças crônicas e saúde bucal: Brasil e grandes regiões. IBGE, Coordenação de Trabalho e Rendimento. Rio de Janeiro: IBGE; 2020. 113p.
  • 4.
    United Nations. Transforming our world: the 2030 agenda for sustainable development. general assembly; 2015. [accessed on Aug. 15, 2021]. Available at: https://www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1⟪=E
    » https://www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1⟪=E
  • 5.
    Malta DC, Duncan BB, Schmidt MI, Teixeira R, Ribeiro ALP, Felisbino-Mendes MS, et al. Trends in mortality due to non-communicable diseases in the Brazilian adult population: national and subnational estimates and projections for 2030. Popul Health Metr 2020; 18 (Suppl 1): 16. https://doi.org/10.1186/s12963-020-00216-1
    » https://doi.org/10.1186/s12963-020-00216-1

  • Financial support: National Health Fund (TED 66/2018). Secretariat of Health Surveillance, Ministry of Health.

Publication Dates

  • Publication in this collection
    10 Dec 2021
  • Date of issue
    2021

History

  • Preprint
    13 Sept 2021
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