Self-rated health according to sex and associated factors in Manaus, Brazil, 2019: a population-based cross-sectional study

Nakamura, Isabella Bagni; Silva, Marcus Tolentino; Galvão, Taís Freire

doi:10.1590/S2237-96222024V33E2023154.EN

Acessibilidade / Reportar erro

Brasil

Epidemiologia e Serviços de Saúde

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 33 • 2024 • https://doi.org/10.1590/S2237-96222024V33E2023154.EN copy

Self-rated health according to sex and associated factors in Manaus, Brazil, 2019: a population-based cross-sectional study

Autoevaluación de la salud según sexo y factores asociados en Manaus, Brasil, 2019: estudio transversal de base poblacional

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To assess the prevalence and factors associated with poor self-rated health according to respondents’ sex in Manaus, Brazil.

Methods:

This was a cross-sectional population-based study with adults in Manaus in 2019. Adjusted prevalence ratios and 95% confidence intervals (95%CI) were calculated using Poisson regression following a hierarchical model.

Results:

Poor self-rated health occurred in 35.2% (95%CI 33.3;37.2) of the 2,321 participants and was higher in females (PR = 1.27; 95%CI 1.13;1.43). In the general population, among both sexes, poor self-rated health was higher among the oldest, those with moderate and severe food insecurity and with chronic diseases (p-value < 0.05). Among females, poor health was also higher among the evangelical and those with mild food insecurity. Among males, self-rated health was also poorer among the retired and those with education below elementary level (p-value < 0.001).

Conclusion:

The female sex had the poorest health rating, influenced by morbidity and access to food.

Keywords:
Self-Assessment; Gender Inequality; Cross-Sectional Studies; Chronic Disease; Food Insecurity

Variables	Total N (%)	Poor health N (%)	p-value
Sex			< 0.001
Male	1,088 (47.8)	322 (29.3)
Female	1,233 (52.2)	501 (40.7)
Age group (years)			< 0.001
18-24	405 (19.3)	105 (25.6)
25-34	586 (25.1)	160 (27.2)
35-44	553 (22.8)	177 (31.9)
45-59	526 (21.2)	242 (45.9)
≥ 60	251 (11.6)	139 (55.5)
Race/skin color			0.745
White	349 (15.0)	121 (34.5)
Black	1,972 (85.0)	702 (35.4)
Occupation			< 0.001
Formal work	419 (17.9)	110 (26.2)
Informal work	661 (28.1)	222 (33.3)
Retired	162 (7.2)	90 (55.4)
Student/housewife	124 (5.7)	30 (23.7)
Unemployed	955 (41.1)	371 (38.6)
Economic classification			< 0.001
A/B	282 (12.3)	83 (29.2)
C	1,244 (53.6)	414 (33.0)
D/E	795 (34.1)	326 (40.8)
Schooling			< 0.001
Higher education or above	153 (6.5)	42 (27.3)
High school education	1,171 (50.4)	338 (28.5)
Elementary education	432 (18.9)	159 (36.7)
Below elementary	565 (24.2)	284 (50.2)
Religion			0.081
Catholic	931 (39.9)	317 (33.9)
Evangelical	1,054 (45.4)	401 (37.8)
Other	137 (5.9)	43 (31.4)
None	199 (8.8)	62 (30.5)
Food insecurity^a			< 0.001
None	777 (33.8)	204 (26.2)
Mild	874 (37.7)	286 (32.4)
Moderate	319 (13.8)	153 (47.9)
Severe	345 (14.7)	179 (51.4)
Body composition			0.002
Eutrophy	971 (42.6)	322 (32.9)
Overweight	792 (33.8)	296 (33.7)
Obesity	558 (23.6)	232 (41.6)
No. of chronic diseases			< 0.001
0	921 (40.1)	164 (17.8)
1	682 (29.3)	218 (31.8)
≥ 2	718 (30.6)	441 (61.4)

Variables	Unadjusted PR (95%CI)	p-value	Adjusted PR (95%CI)	p-value
First level
Sex		< 0.001		< 0.001
Male	1.00		1.00
Female	1.39 (1.24;1.56)		1.27 (1.13;1.43)
Age group (years)		< 0.001		< 0.001
18-24	1.00		1.00
25-34	1.06 (0.86;1.31)		1.10 (0.88;1.36)
35-44	1.25 (1.02;1.53)		1.26 (1.01;1.56)
45-59	1.79 (1.48;2.17)		1.78 (1.45;2.19)
≥ 60	2.17 (1.78;2.64)		1.85 (1.46;2.34)
Race/skin color		0.746
White	1.00
Black	1.03 (0.88;1.20)
Occupation		< 0.001		0.057
Formal work	1.00		1.00
Informal work	1.27 (1.05;1.54)		1.06 (0.87;1.29)
Retired	2.11 (1.71;2.62)		1.29 (1.02;1.64)
Student/housewife	0.91 (0.64;1.29)		1.02 (0.70;1.48)
Unemployed	1.47 (1.23;1.77)		1.23 (1.02;1.49)
Economic classification		< 0.001		0.600
A/B	1.00		1.00
C	1.13 (0.93;1.38)		0.99 (0.81;1.20)
D/E	1.40 (1.15;1.71)		1.05 (0.85;1.29)
Schooling		< 0.001		< 0.001
Higher education or above	1.00		1.00
High school education	1.05 (0.79;1.37)		1.05 (0.80;1.38)
Elementary education	1.34 (1.01;1.79)		1.34 (1.00;1.79)
Below elementary	1.84 (1.40;2.42)		1.45 (1.09;1.92)
Religion		0.085		0.060
Catholic	1.00		1.00
Evangelical	1.12 (0.99;1.26)		1.17 (1.04;1.31)
Other	0.93 (0.71;1.21)		1.05 (0.81;1.37)
None	0.90 (0.72;1.13)		1.14 (0.91;1.44)
Second level
Food insecurity		< 0.001		< 0.001
None	1.00		1.00
Mild	1.24 (1.06;1.44)		1.22 (1.05;1.41)
Moderate	1.83 (1.55;2.16)		1.70 (1.45;1.99)
Severe	1.96 (1.68;2.30)		1.67 (1.43;1.95)
Body composition		0.001		0.067
Eutrophy	1.00		1.00
Overweight	1.02 (0.90;1.17)		1.02 (0.90;1.16)
Obesity	1.27 (1.11;1.45)		1.16 (1.01;1.32)
Third level
No. of chronic diseases		< 0.001		< 0.001
0	1.00		1.00
1	1.79 (1.50;2.14)		1.71 (1.44;2.04)
≥ 2	3.46 (2.97;4.02)		2.90 (2.47;3.40)

Variables	Female sex (N = 1,233)				Male sex (N = 1,088)
Variables	Unadjusted PR (95%CI)	p-value	Adjusted PR (95%CI)	p-value	Unadjusted PR (95%CI)	p-value	Adjusted PR (95%CI)	p-value
First level
Age group (years)		< 0,001		< 0.001		< 0.001		0.005
18-24	1.00		1.00		1.00		1.00
25-34	1.01 (0.79;1.31)		1.04 (0.80;1.35)		1.13 (0.78;1.63)		1.16 (0.79;1.69)
35-44	1.08 (0.84;1.39)		1.13 (0.86;1.47)		1.51 (1.07;2.13)		1.45 (1.00;2.10)
45-59	1.66 (1.33;2.08)		1.75 (1.37;2.25)		1.97 (1.42;2.75)		1.75 (1.23;2.50)
≥ 60	1.88 (1.48;2.39)		1.83 (1.39;2.42)		2.57 (1.82;3.63)		1.78 (1.17;2.71)
Race/skin color		0.688				0.513
White	1.00		1.00		1.00		1.00
Black	0.96 (0.80;1.16)				1.09 (0.84;1.42)
Occupation		0.002		0.339		< 0.001
Formal work	1.00		1.00		1.00		1.00	0.127
Informal work	1.26 (0.94;1.71)		1.06 (0.78;1.44)		1.22 (0.94;1.57)		1.03 (0.80;1.34)
Retired	1.82 (1.31;2.53)		1.18 (0.83;1.68)		2.25 (1.70;2.98)		1.42 (1.01;2.02)
Student/housewife	1.03 (0.67;1.59)		1.19 (0.75;1.88)		0.60 (0.31;1.18)		0.76 (0.37;1.53)
Unemployed	1.36 (1.03;1.79)		1.24 (0.93;1.64)		1.23 (0.93;1.62)		1.21 (0.92;1.60)
Economic classification		0.037		0.722		0.008		0.454
A/B	1.00		1.00		1.00		1.00
C	1.18 (0.90;1.54)		1.10 (0.84;1.44)		1.02 (0.76;1.37)		0.86 (0.64;1.16)
D/E	1.35 (1.03;1.77)		1.12 (0.85;1.49)		1.37 (1.01;1.85)		0.96 (0.70;1.31)
Schooling		< 0.001		0.010		< 0.001		0.002
Higher education or above	1.00		1.00		1.00		1.00
High school education	1.01 (0.74;1.39)		0.96 (0.69;1.32)		1.19 (0.71;1.98)		1.25 (0.75;2.07)
Elementary education	1.32 (0.95;1.84)		1.23 (0.88;1.72)		1.47 (0.86;2.52)		1.60 (0.93;2.74)
Below elementary	1.61 (1.17;2.20)		1.23 (0.88;1.70)		2.38 (1.43;3.95)		1.94 (1.15;3.29)
Religion		0.067		0.016		0.887
Catholic	1.00		1.00		1.00		1.00
Evangelical	1.18 (1.02;1.37)		1.26 (1.09;1.46)		0.94 (0.76;1.15)
Other	1.01 (0.71;1.45)		1.08 (0.75;1.56)		0.89 (0.60;1.30)
None	0.88 (0.64;1.21)		1.11 (0.80;1.54)		0.94 (0.68;1.30)
Second level
Food insecurity		< 0.001		< 0.001		< 0.001		< 0.001
None	1.00		1.00		1.00		1.00
Mild	1.35 (1.09;1.65)		1.33 (1.09;1.62)		1.06 (0.84;1.34)		1.10 (0.88;1.38)
Moderate	1.87 (1.50;2.33)		1.74 (1.40;2.15)		1.68 (1.29;2.18)		1.69 (1.31;2.18)
Severe	2.14 (1.75;2.63)		1.87 (1.52;2.30)		1.57 (1.20;2.05)		1.44 (1.10;1.87)
Body composition		0.079		0.359		0.061		0.167
Eutrophy	1.00		1.00		1.00		1.00
Overweight	0.99 (0.84;1.17)		0.99 (0.84;1.16)		1.09 (0.88;1.35)		1.04 (0.85;1.28)
Obesity	1.17 (1.00;1.37)		1.10 (0.94;1.28)		1.32 (1.05;1.67)		1.24 (0.98;1.57)
Third level
No. of chronic diseases		< 0.001		< 0.001		< 0.001		< 0.001
0	1.00		1.00		1.00		1.00
1	1.67 (1.33;2.09)		1.61 (1.29;2.00)		1.90 (1.43;2.53)		1.80 (1.36;2.39)
≥ 2	2.75 (2.27;3.33)		2.37 (1.94;2.89)		4.44 (3.49;5.65)		3.84 (2.97;4.90)

Variables	Female sex (N = 1,233)			Male sex (N = 1,088)
Variables	Total n (%)	Poor health n (%)	p-value	Total n (%)	Poor health n (%)	p-value
Age group (years)			< 0.001			< 0.001
18-24	213 (18.5)	68 (31.9)		192 (20.1)	37 (19.3)
25-34	306 (24.8)	99 (32.4)		280 (25.5)	61 (21.8)
35-44	295 (22.9)	102 (34.6)		258 (22.8)	75 (29.1)
45-59	279 (21.2)	148 (53.1)		247 (21.1)	94 (38.1)
≥ 60	140 (12.6)	84 (60.0)		111 (10.5)	55 (49.6)
Race/skin color			0.691			0.507
White	174 (14.1)	73 (42.0)		175 (16.1)	48 (27.2)
Black	1,059 (85.9)	428 (40.4)		913 (83.9)	274 (29.7)
Occupation			0.003			< 0.001
Formal work	126 (10.0)	39 (30.9)		293 (26.6)	71 (24.2)
Informal work	268 (21.3)	105 (39.1)		393 (35.5)	117 (29.5)
Retired	76 (6.5)	43 (56.2)		86 (7.9)	47 (54.6)
Student/housewife	69 (5.9)	22 (31.8)		55 (5.6)	8 (14.5)
Unemployed	694 (56.3)	292 (42.1)		261 (24.4)	79 (29.8)
Economic classification			0.033			0.009
A/B	126 (10.2)	42 (33.2)		156 (14.4)	41 (26.0)
C	651 (52.9)	255 (39.2)		593 (54.4)	159 (26.5)
D/E	456 (36.9)	204 (44.9)		339 (31.2)	122 (35.6)
Schooling			< 0.001			< 0.001
Higher education or above	87 (7.0)	29 (33.3)		66 (5.9)	13 (19.5)
High school education	605 (48.8)	205 (33.8)		566 (52.2)	133 (23.1)
Elementary education	230 (18.9)	101 (44.0)		202 (18.9)	58 (28.6)
Below elementary	311 (25.3)	166 (53.5)		254 (23.0)	118 (46.3)
Religion			0.059			0.887
Catholic	454 (36.8)	170 (37.5)		477 (43.4)	147 (30.5)
Evangelical	636 (51.6)	281 (44.2)		418 (38.6)	120 (28.6)
Other	56 (4.5)	21 (38.1)		81 (7.4)	22 (27.0)
None	87 (7.1)	29 (33.0)		112 (10.6)	33 (28.7)
Food insecurity^a			< 0.001			< 0.001
None	345 (28.2)	95 (27.8)		432 (39.9)	109 (25.0)
Mild	484 (39.3)	181 (37.4)		390 (35.9)	105 (26.5)
Moderate	191 (15.5)	99 (52.0)		128 (11.8)	54 (42.0)
Severe	211 (17.0)	126 (59.6)		134 (12.4)	53 (39.2)
Body composition			0.089			0.068
Eutrophy	499 (41.0)	194 (39.0)		472 (44.3)	128 (26.8)
Overweight	392 (31.6)	151 (38.5)		400 (36.2)	118 (29.1)
Obesity	342 (27.4)	156 (45.7)		216 (19.5)	76 (35.4)
No. of chronic diseases			< 0.001			< 0.001
0	433 (35.3)	96 (22.3)		488 (45.4)	68 (13.9)
1	349 (28.2)	129 (37.1)		333 (30.5)	89 (26.5)
≥ 2	451 (36.5)	276 (61.2)		267 (2)	165 (61.8)

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence:
Taís Freire Galvão.
E-mail:
taisgalvao@gmail.com