title: Social inequalities in the prevalence of self-reported chronic non-communicable diseases in Brazil: national health survey 2013.
abstract: Considering the high socioeconomic inequalities in Brazil related to occurrence of morbidity and premature mortality, the objective of this study was to analyze inequalities in self-reported prevalence of Non-Communicable Diseases (NCD) and in the physical limitations caused by these diseases, among the Brazilian adult population, according to sociodemographic variables.
  
  
  
  This was a population-based cross-sectional study that analyzed information on 60,202 individuals who formed a representative sample of Brazilian adults interviewed for the National Health Survey 2013. Disparities by schooling levels and possession of private health insurance were assessed by calculating the prevalence (P) and prevalence ratio (PR) of each of the 13 NCDs and any associated limitations, while controlling for other socioeconomic and demographic variables.
  
  
  
  45 % of the Brazilian adult population reported having at least one NCD. The prevalence ratio was greater among women (1.24 CI 1.21-1.28), individuals over 55 years of age, individuals with low schooling levels (illiterate and incomplete elementary education) (1.08 CI 1.02-1.14) and people living in the Southeast (1.10 CI 1.04-1.16), South (1.26 CI 1.19-1.34) and Central-West (1.11 CI 1.05-1.18) regions of the country. Diseases such as diabetes (1.42 CI 1.13-1.47), hypertension (1.17 CI 1.06-1.28), stroke (2.52 CI 1.74-3.66), arthritis (1.4 CI 1.11-1.77), spinal problems (1.39 CI .1.25-1.56), and chronic renal failure (1.65 CI 1.10.2.46), were more prevalent among adults with low education. For most NCDs, greater reports of limitations were associated with lower schooling levels and lack of private health insurance.
  
  
  
  Populations with lower schooling levels and lack of private health insurance present higher prevalence of various NCD and greater degrees of limitation due to these diseases. Results reveal the extent of social inequalities that persist with regard to occurrence and the impact of NCDs in Brazil.
authors.affiliation: Nursing School, Universidade Federal de Minas Gerais (UFMG), Avenida Alfredo Balena, 190 Santa Efigenia, CEP - 30.130.100, Belo Horizonte, Minas Gerais, Brazil. dcmalta@uol.com.br.
authors.forename: Deborah Carvalho
authors.identifier: 0000-0002-8214-5734
authors.initials: DC
authors.lastname: Malta
authors.affiliation: Center for Epidemiological Research on Nutrition and Health School of Public Health, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Regina Tomie Ivata
authors.initials: RT
authors.lastname: Bernal
authors.affiliation: Department of Non-communicable diseases and Health Promotion - Ministry of Health of Brazil, Brasilia, Brazil.
authors.forename: Maria de Fatima Marinho
authors.initials: MF
authors.lastname: de Souza
authors.affiliation: Center for Scientific and Technological Information, Department of Health Information, Oswaldo Cruz Foundation, Manguinhos, Brazil.
authors.forename: Celia Landman
authors.initials: CL
authors.lastname: Szwarcwald
authors.affiliation: Department of Public Health, School of Medical Sciences, UNICAMP, São Paulo, Brazil.
authors.forename: Margareth Guimarães
authors.initials: MG
authors.lastname: Lima
authors.affiliation: Department of Public Health, School of Medical Sciences, UNICAMP, São Paulo, Brazil.
authors.forename: Marilisa Berti de Azevedo
authors.initials: MB
authors.lastname: Barros
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012923:Social Class; D013122:Spinal Diseases / Q000453:epidemiology; D055815:Young Adult
keywords: Chronic disease; Functional limitations; Health insurance; Inequalities; Low schooling level