title: Associations between noncommunicable disease risk factors, race, education, and health insurance status among women of reproductive age in Brazil - 2011.
abstract: BACKGROUND
  Noncommunicable disease (NCD) risk factors increase the risk of adverse reproductive health outcomes and are becoming increasingly common in Brazil.
  
  
  METHODS
  We analyzed VIGITEL 2011 telephone survey data for 13,745 Brazilian women aged 18-44 years in a probabilistic sample from 26 Brazilian state capitals and the Federal District. We examined associations between NCD risk factors (fruit and vegetable intake, leisure time physical activity, alcohol consumption, smoking status, BMI and hypertension status) and race, education, and insurance using chi-square tests and multivariable logistic regression models, estimating the average marginal effects to produce adjusted relative risk ratios (aRRs). Analyses were conducted using SAS 9.3 survey procedures and weighted to reflect population estimates.
  
  
  RESULTS
  Women with less than a college education were more likely to report physical inactivity (adjusted relative risk (aRR) and 95% confidence interval = 1.1 (1.1-1.2)), smoking (aRR = 1.7 (1.3-2.2)), and self-reported diagnoses of hypertension (aRR = 2.0 (1.6-2.5)) compared to women with a college education or greater. Similarly, women without health insurance were more likely to report physical inactivity (aRR = 1.1 (1.1-1.2)), smoking (aRR = 1.4 (1.1-1.8)), and self-reported diagnoses of hypertension aRR = 1.4 (1.1-1.7)) compared to women with health insurance. Less variation was found by race and NCD risk factors.
  
  
  CONCLUSIONS
  Targeted public health strategies and policies are needed to increase healthcare access and decrease educational and racial disparities in NCD risk factors among women of reproductive age in Brazil.
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-F-74, Atlanta, GA 30341, United States; U.S. Public Health Service Commissioned Corps, 1101 Wooten Parkway, Rockville, MD 20852, United States.
authors.forename: Jonetta Johnson
authors.initials: JJ
authors.lastname: Mpofu
authors.affiliation: Pan-Americana Health Organization, Brasilia, Distrito Federal, Brazil.
authors.forename: Lenildo
authors.initials: L
authors.lastname: de Moura
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-F-74, Atlanta, GA 30341, United States.
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Farr
authors.affiliation: Ministry of Health of Brazil, Section 2, Lots 05/06, Premium Building, Block F, Tower 1, Brasilia, DF, Brazil.
authors.forename: Deborah Carvalho
authors.initials: DC
authors.lastname: Malta
authors.affiliation: Ministry of Health of Brazil, Section 2, Lots 05/06, Premium Building, Block F, Tower 1, Brasilia, DF, Brazil.
authors.forename: Betine Moehlecke
authors.initials: BM
authors.lastname: Iser
authors.affiliation: Ministry of Health of Brazil, Section 2, Lots 05/06, Premium Building, Block F, Tower 1, Brasilia, DF, Brazil.
authors.forename: Regina Tomie
authors.initials: RT
authors.lastname: Ivata Bernal
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-F-74, Atlanta, GA 30341, United States.
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Robbins
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Mailstop 1518-002-7BB, Atlanta, GA 30322, United States.
authors.forename: Felipe
authors.initials: F
authors.lastname: Lobelo
keywords: Chronic disease; Education; Health; Insurance; Reproductive health; Risk factors; Women