Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis

BACKGROUND: Information about multimorbidity is scarce in developing countries. This study aimed to estimate the association of educational attainment with occurrences of multimorbidity in a population of public employees on university campuses in Rio de Janeiro. DESIGN AND SETTING: We conducted cro...

Full description

Bibliographic Details
Authors: Jantsch, Adelson Guaraci, Alves, Ronaldo Fernandes Santos, Faerstein, Eduardo
Format: article
Status:Published version
Publication Date:2018
Country:Brasil
Institution:Associação Paulista de Medicina
Repository:São Paulo medical journal (Online)
Language:English
OAI Identifier:oai:ojs.diagnosticoetratamento.emnuvens.com.br:article/1465
Online Access:https://periodicosapm.emnuvens.com.br/spmj/article/view/1465
Access Level:Open access
Keyword:Comorbidity
Health status disparities
Educational status
Cross-sectional studies
id BR_bbb3c210de25243a41bbcf2cb77db2d0
oai_identifier_str oai:ojs.diagnosticoetratamento.emnuvens.com.br:article/1465
network_acronym_str BR
network_name_str Brasil
repository_id_str
spelling Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysisComorbidityHealth status disparitiesEducational statusCross-sectional studiesBACKGROUND: Information about multimorbidity is scarce in developing countries. This study aimed to estimate the association of educational attainment with occurrences of multimorbidity in a population of public employees on university campuses in Rio de Janeiro. DESIGN AND SETTING: We conducted cross-sectional analyses on baseline data (1999-2001) from 3,253 participants in the Pró-Saúde study, conducted in Brazil. METHODS: The prevalence of multimorbidity, defined as a self-reported history of medical diagnoses of two or more chronic conditions, was estimated according to sex, age, smoking, obesity and educational level. The association between education and multimorbidity was estimated using odds ratios (OR) and the relative and slope indices of inequality, in order to quantify the degree of educational inequality among individuals with multimorbidity in this population. RESULTS: Greater age, female sex, smoking and obesity had direct associations with multimorbidity; and tobacco exposure and obesity also showed direct relationships with poorer educational level. There was a monotonic inverse linear trend between educational level and the presence of multimorbidity among women, with twice the odds (OR 2.47; 95% confidence interval, CI: 1.42-4.40) between extremities of schooling categories. There was excess multimorbidity of 22% at the lowest extremity of schooling, thus showing that women with worse educational status were more affected by the outcome. No trend and no excess multimorbidity was seen among men. CONCLUSIONS: Educational inequality is an important determinant for development of multimorbidity. Men and women experience its effect differently. Researchers need to consider that sex may be an effect modifier in multimorbidity studies.São Paulo Medical JournalSão Paulo Medical Journal2018-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://periodicosapm.emnuvens.com.br/spmj/article/view/1465São Paulo Medical Journal; Vol. 136 No. 1 (2018); 51-58São Paulo Medical Journal; v. 136 n. 1 (2018); 51-581806-9460reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APMenghttps://periodicosapm.emnuvens.com.br/spmj/article/view/1465/1369https://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessJantsch, Adelson GuaraciAlves, Ronaldo Fernandes SantosFaerstein, Eduardo2023-08-31T21:31:31Zoai:ojs.diagnosticoetratamento.emnuvens.com.br:article/1465Revistahttp://www.scielo.br/spmjPUBhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2023-08-31T21:31:31São Paulo medical journal (Online) - Associação Paulista de Medicinafalse
dc.title.none.fl_str_mv Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis
title Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis
spellingShingle Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis
Jantsch, Adelson Guaraci
Comorbidity
Health status disparities
Educational status
Cross-sectional studies
title_short Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis
title_full Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis
title_fullStr Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis
title_full_unstemmed Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis
title_sort Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis
dc.creator.none.fl_str_mv Jantsch, Adelson Guaraci
Alves, Ronaldo Fernandes Santos
Faerstein, Eduardo
author Jantsch, Adelson Guaraci
author_facet Jantsch, Adelson Guaraci
Alves, Ronaldo Fernandes Santos
Faerstein, Eduardo
author_role author
author2 Alves, Ronaldo Fernandes Santos
Faerstein, Eduardo
author2_role author
author
dc.subject.por.fl_str_mv Comorbidity
Health status disparities
Educational status
Cross-sectional studies
topic Comorbidity
Health status disparities
Educational status
Cross-sectional studies
description BACKGROUND: Information about multimorbidity is scarce in developing countries. This study aimed to estimate the association of educational attainment with occurrences of multimorbidity in a population of public employees on university campuses in Rio de Janeiro. DESIGN AND SETTING: We conducted cross-sectional analyses on baseline data (1999-2001) from 3,253 participants in the Pró-Saúde study, conducted in Brazil. METHODS: The prevalence of multimorbidity, defined as a self-reported history of medical diagnoses of two or more chronic conditions, was estimated according to sex, age, smoking, obesity and educational level. The association between education and multimorbidity was estimated using odds ratios (OR) and the relative and slope indices of inequality, in order to quantify the degree of educational inequality among individuals with multimorbidity in this population. RESULTS: Greater age, female sex, smoking and obesity had direct associations with multimorbidity; and tobacco exposure and obesity also showed direct relationships with poorer educational level. There was a monotonic inverse linear trend between educational level and the presence of multimorbidity among women, with twice the odds (OR 2.47; 95% confidence interval, CI: 1.42-4.40) between extremities of schooling categories. There was excess multimorbidity of 22% at the lowest extremity of schooling, thus showing that women with worse educational status were more affected by the outcome. No trend and no excess multimorbidity was seen among men. CONCLUSIONS: Educational inequality is an important determinant for development of multimorbidity. Men and women experience its effect differently. Researchers need to consider that sex may be an effect modifier in multimorbidity studies.
publishDate 2018
dc.date.none.fl_str_mv 2018-02-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://periodicosapm.emnuvens.com.br/spmj/article/view/1465
url https://periodicosapm.emnuvens.com.br/spmj/article/view/1465
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://periodicosapm.emnuvens.com.br/spmj/article/view/1465/1369
dc.rights.driver.fl_str_mv https://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv São Paulo Medical Journal
São Paulo Medical Journal
publisher.none.fl_str_mv São Paulo Medical Journal
São Paulo Medical Journal
dc.source.none.fl_str_mv São Paulo Medical Journal; Vol. 136 No. 1 (2018); 51-58
São Paulo Medical Journal; v. 136 n. 1 (2018); 51-58
1806-9460
reponame:São Paulo medical journal (Online)
instname:Associação Paulista de Medicina
instacron:APM
instname_str Associação Paulista de Medicina
instacron_str APM
institution APM
reponame_str São Paulo medical journal (Online)
collection São Paulo medical journal (Online)
repository.name.fl_str_mv São Paulo medical journal (Online) - Associação Paulista de Medicina
repository.mail.fl_str_mv revistas@apm.org.br
_version_ 1853676241569185792
score 15.301629

Similar Items