Cargando…

A priority health index identifies the top six priority risk and related factors for non-communicable diseases in Brazilian cities

BACKGROUND: In Brazil, 72% of all deaths in 2007 were attributable to non-communicable diseases (NCD). We used a risk and related factor based index to prioritize NCD prevention programs in the combined 26 capital cities and the federal district (i.e., Brasilia) of Brazil. METHODS: We used 2006–2011...

Descripción completa

Detalles Bibliográficos
Autores principales: Simoes, Eduardo J, Bouras, Adam, Cortez-Escalante, Juan Jose, Malta, Deborah C, Porto, Denise Lopes, Mokdad, Ali H, de Moura, Lenildo, Neto, Otaliba Libanio Morais
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425866/
https://www.ncbi.nlm.nih.gov/pubmed/25924606
http://dx.doi.org/10.1186/s12889-015-1787-1
_version_ 1782370532425990144
author Simoes, Eduardo J
Bouras, Adam
Cortez-Escalante, Juan Jose
Malta, Deborah C
Porto, Denise Lopes
Mokdad, Ali H
de Moura, Lenildo
Neto, Otaliba Libanio Morais
author_facet Simoes, Eduardo J
Bouras, Adam
Cortez-Escalante, Juan Jose
Malta, Deborah C
Porto, Denise Lopes
Mokdad, Ali H
de Moura, Lenildo
Neto, Otaliba Libanio Morais
author_sort Simoes, Eduardo J
collection PubMed
description BACKGROUND: In Brazil, 72% of all deaths in 2007 were attributable to non-communicable diseases (NCD). We used a risk and related factor based index to prioritize NCD prevention programs in the combined 26 capital cities and the federal district (i.e., Brasilia) of Brazil. METHODS: We used 2006–2011 data (adults) from census and Brazil's surveillance of 12 NCD risk factors and 74 disease group mortality. The risk and related factors were: smoking, physical inactivity, overweight-obesity, low fruits and vegetables intake, binge drinking, insufficient Pap smear screening (women aged 25 to 59 years), insufficient mammography screening (women aged 50 to 69 years), insufficient blood pressure screening, insufficient blood glucose screening, diagnosis of hypercholesterolemia, diagnosis of hypertension and diagnosis of diabetes. We generated six indicators: intervention reduction of the risk factor prevalence, intervention cost per person, prevalence of risk factor, deaths attributable to risk factor, risk factor prevalence trend and ratio of risk factor prevalence between people with and without a high school education. We transformed risk and related factor indicators into priority scores to compute a priority health index (PHI). We implemented sensitivity analysis of PHI by computing it with slightly altered formulas and altering values of indicators under the assumption of bias in their estimation. We ranked risk factors based on PHI values. RESULTS: We found one intermediate (i.e., overweight-obesity) and six top risk and related factors priorities for NCD prevention in Brazil's large urban areas: diagnosed hypertension, physical inactivity, blood pressure screening, diagnosed hypercholesterolemia, smoking and binge drinking. CONCLUSION: Brazil has already prioritized the six top priorities (i.e., hypertension, physical inactivity, blood pressure screening, hypercholesterolemia, smoking and binge drinking) and one intermediate priority (i.e., overweight-obesity) for NCD prevention identified in this report. Because effective interventions to reduce disease burden associated with each of the six priority risk factors are available, strategies based on these interventions need to be sustained in order to reduce NCD burden in Brazil. PHI can be used to track NCD prevention and health promotion actions at the local and national level in Brazil and in countries with similar public health surveillance systems. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-015-1787-1) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-4425866
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-44258662015-05-10 A priority health index identifies the top six priority risk and related factors for non-communicable diseases in Brazilian cities Simoes, Eduardo J Bouras, Adam Cortez-Escalante, Juan Jose Malta, Deborah C Porto, Denise Lopes Mokdad, Ali H de Moura, Lenildo Neto, Otaliba Libanio Morais BMC Public Health Research Article BACKGROUND: In Brazil, 72% of all deaths in 2007 were attributable to non-communicable diseases (NCD). We used a risk and related factor based index to prioritize NCD prevention programs in the combined 26 capital cities and the federal district (i.e., Brasilia) of Brazil. METHODS: We used 2006–2011 data (adults) from census and Brazil's surveillance of 12 NCD risk factors and 74 disease group mortality. The risk and related factors were: smoking, physical inactivity, overweight-obesity, low fruits and vegetables intake, binge drinking, insufficient Pap smear screening (women aged 25 to 59 years), insufficient mammography screening (women aged 50 to 69 years), insufficient blood pressure screening, insufficient blood glucose screening, diagnosis of hypercholesterolemia, diagnosis of hypertension and diagnosis of diabetes. We generated six indicators: intervention reduction of the risk factor prevalence, intervention cost per person, prevalence of risk factor, deaths attributable to risk factor, risk factor prevalence trend and ratio of risk factor prevalence between people with and without a high school education. We transformed risk and related factor indicators into priority scores to compute a priority health index (PHI). We implemented sensitivity analysis of PHI by computing it with slightly altered formulas and altering values of indicators under the assumption of bias in their estimation. We ranked risk factors based on PHI values. RESULTS: We found one intermediate (i.e., overweight-obesity) and six top risk and related factors priorities for NCD prevention in Brazil's large urban areas: diagnosed hypertension, physical inactivity, blood pressure screening, diagnosed hypercholesterolemia, smoking and binge drinking. CONCLUSION: Brazil has already prioritized the six top priorities (i.e., hypertension, physical inactivity, blood pressure screening, hypercholesterolemia, smoking and binge drinking) and one intermediate priority (i.e., overweight-obesity) for NCD prevention identified in this report. Because effective interventions to reduce disease burden associated with each of the six priority risk factors are available, strategies based on these interventions need to be sustained in order to reduce NCD burden in Brazil. PHI can be used to track NCD prevention and health promotion actions at the local and national level in Brazil and in countries with similar public health surveillance systems. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-015-1787-1) contains supplementary material, which is available to authorized users. BioMed Central 2015-05-01 /pmc/articles/PMC4425866/ /pubmed/25924606 http://dx.doi.org/10.1186/s12889-015-1787-1 Text en © Simoes et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Simoes, Eduardo J
Bouras, Adam
Cortez-Escalante, Juan Jose
Malta, Deborah C
Porto, Denise Lopes
Mokdad, Ali H
de Moura, Lenildo
Neto, Otaliba Libanio Morais
A priority health index identifies the top six priority risk and related factors for non-communicable diseases in Brazilian cities
title A priority health index identifies the top six priority risk and related factors for non-communicable diseases in Brazilian cities
title_full A priority health index identifies the top six priority risk and related factors for non-communicable diseases in Brazilian cities
title_fullStr A priority health index identifies the top six priority risk and related factors for non-communicable diseases in Brazilian cities
title_full_unstemmed A priority health index identifies the top six priority risk and related factors for non-communicable diseases in Brazilian cities
title_short A priority health index identifies the top six priority risk and related factors for non-communicable diseases in Brazilian cities
title_sort priority health index identifies the top six priority risk and related factors for non-communicable diseases in brazilian cities
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425866/
https://www.ncbi.nlm.nih.gov/pubmed/25924606
http://dx.doi.org/10.1186/s12889-015-1787-1
work_keys_str_mv AT simoeseduardoj apriorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT bourasadam apriorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT cortezescalantejuanjose apriorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT maltadeborahc apriorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT portodeniselopes apriorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT mokdadalih apriorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT demouralenildo apriorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT netootalibalibaniomorais apriorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT simoeseduardoj priorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT bourasadam priorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT cortezescalantejuanjose priorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT maltadeborahc priorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT portodeniselopes priorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT mokdadalih priorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT demouralenildo priorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities
AT netootalibalibaniomorais priorityhealthindexidentifiesthetopsixpriorityriskandrelatedfactorsfornoncommunicablediseasesinbraziliancities