Browsing by Author "Roux, Ana V. Diez"

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    Association between perceived neighbourhood characteristics, physical activity and diet quality : results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
    (2016) Chor, Dóra; Cardoso, Letícia de Oliveira; Nobre, Aline Araújo; Griep, Rosane Härter; Fonseca, Maria de Jesus Mendes da; Giatti, Luana; Benseñor, Isabela Judith Martins; Molina, Maria del Carmen Bisi; Aquino, Estela M. L.; Roux, Ana V. Diez; Castiglione, Débora de Pina; Santos, Simone M.
    Background: The study explores associations between perceived neighbourhood characteristics, physical activity and diet quality, which in Latin America and Brazil have been scarcely studied and with inconsistent results. Methods: We conducted a cross-sectional analysis of 14,749 individuals who participated in the Brazilian Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto, ELSA-Brasil) baseline. The study included current and retired civil servants, aged between 35 and 74 years, from universities and research institutes in six Brazilian states. The International Physical Activity Questionnaire (IPAQ) long form was used to characterize physical activity during leisure time and commuting; additional questions assessed how often fruit and vegetables were consumed, as a proxy for diet quality. Neighbourhood characteristics were evaluated by the “Walking Environment” and “Availability of Healthy Foods” scales originally used in the Multi-Ethnic Study of Atherosclerosis (MESA). Associations were examined using multinomial logistic regression. Results: Perceiving a more walkable neighbourhood was positively associated with engaging in leisure time physical activity and doing so for longer weekly. Compared with those who saw their neighbourhood as less walkable, those who perceived it as more walkable had 1.69 (95 % CI 1.57–1.83) and 1.39 (1.28–1.52) greater odds of engaging in leisure time physical activity for more than 150 min/week or up to 150 min/week (vs. none), respectively. Perceiving a more walkable neighbourhood was also positively associated with transport-related physical activity. The same pattern was observed for diet: compared with participants who perceived healthy foods as less available in their neighbourhood, those who saw them as more available had odds 1.48 greater (1.31–1.66) of eating fruits, and 1.47 greater (1.30–1.66) of eating vegetables, more than once per day. Conclusions: Perceived walkability and neighbourhood availability of healthy food were independently associated with the practice of physical activity and diet quality, respectively, underlining the importance of neighbourhood-level public policies to changing and maintaining health-related habits.
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    Life expectancy and mortality in 363 cities of Latin America.
    (2021) Bilal, Usama; Hessel, Philipp; Pérez Ferrer, Carolina; Michael, Yvonne L.; Alfaro, Tania; Tenorio Mucha, Janeth; Friche, Amélia Augusta de Lima; Pina, Maria de Fátima de; Vives, Alejandra; Quick, Harrison; Alazraqui, Marcio; Rodriguez, Daniel A.; Miranda, J. Jaime; Roux, Ana V. Diez
    The concept of a so-called urban advantage in health ignores the possibility of heterogeneity in health outcomes across cities. Using a harmonized dataset from the SALURBAL project, we describe variability and predictors of life expectancy and propor- tionate mortality in 363 cities across nine Latin American countries. Life expectancy differed substantially across cities within the same country. Cause-specific mortality also varied across cities, with some causes of death (unintentional and violent inju- ries and deaths) showing large variation within countries, whereas other causes of death (communicable, maternal, neonatal and nutritional, cancer, cardiovascular disease and other noncommunicable diseases) varied substantially between countries. In multivariable mixed models, higher levels of education, water access and sanitation and less overcrowding were associated with longer life expectancy, a relatively lower proportion of communicable, maternal, neonatal and nutritional deaths and a higher proportion of deaths from cancer, cardiovascular disease and other noncommunicable diseases. These results highlight considerable heterogeneity in life expectancy and causes of death across cities of Latin America, revealing modifiable factors that could be amenable to urban policies aimed toward improving urban health in Latin America and more generally in other urban environments.
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    Racial inequities in self-rated health across Brazilian cities : does residential segregation play a role?
    (2022) Guimarães, Joanna Miguez Nery; Yamada, Goro; Barber, Sharrelle; Caiaffa, Waleska Teixeira; Friche, Amélia Augusta de Lima; Menezes, Mariana Carvalho de; Santos, Gervasio; Santos, Isabel; Cardoso, Leticia de Oliveira; Roux, Ana V. Diez
    Racial health inequities may be partially explained by area-level factors such as residential segregation. In this cross-sectional study, using a large, multiracial, representative sample of Brazilian adults (n = 37,009 individuals in the 27 state capitals; National Health Survey (Pesquisa Nacional de Saúde), 2013), we investigated 1) whether individual-level self-rated health (SRH) (fair or poor vs. good or better) varies by race (self-declared White, Brown, or Black) and 2) whether city-level economic or racial residential segregation (using dissimilarity index values in tertiles: low, medium, and high) interacts with race, increasing racial inequities in SRH. Prevalence of fair or poor SRH was 31.5% (Black, Brown, and White people: 36.4%, 34.0%, and 27.3%, respectively). Marginal standardization based on multilevel logistic regression models, adjusted for age, gender, and education, showed that Black and Brown people had, respectively, 20% and 10% higher prevalence of fair or poor SRH than did White people. Furthermore, residential segregation interacted with race such that the more segregated a city, the greater the racial gap among Black, Brown, and White people in fair or poor SRH for both income and race segregation. Policies to reduce racial inequities may need to address residential segregation and its consequences for health.