Associations between noncommunicable disease risk factors, race, education, and health insurance status among women of reproductive age in Brazil — 2011

•Examine prevalence of NCD risk factors with race, education, and insurance status•We analyzed data from a probabilistic sample of 13,745 non-pregnant Brazilian women.•Less educated women reported more physical inactivity, smoking, and hypertension.•Uninsured women reported more physical inactivity, smoking and hypertension.•Less variation was found by race and noncommunicable disease risk factors.

ABSTRACTBackgroundNoncommunicable disease (NCD) risk factors increase the risk of adverse reproductive health outcomes and are becoming increasingly common in Brazil.MethodsWe 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.ResultsWomen 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.ConclusionTargeted 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.