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Resumo: Este estudo objetivou mensurar o acesso aos medicamentos para o tratamento da hipertensão arterial sistêmica e diabetes mellitus tipo 2 no Brasil segundo a via de obtenção, bem como analisar os fatores associados a esse acesso, de acordo com os dados da Pesquisa Nacional de Saúde (PNS) de 2019. Foram analisados dados socioeconômicos e relacionados ao uso de medicamentos de pessoas de 15 anos ou mais, em relação ao acesso via Programa Farmácia Popular do Brasil (PFPB) e via serviço público. A maior parte dos brasileiros que participaram da PNS referiu fazer uso do medicamento para controle da hipertensão, nos últimos 15 dias (91,5%), assim como a maior parte referiu fazer uso de medicamento oral para diabetes (95,2%) e/ou uso da insulina (70%).Os medicamentos orais para hipertensão arterial sistêmica e diabetes mellitus tipo 2 foram obtidos majoritariamente via PFPB, sendo respectivamente (45,2% e 53,6%), e os fatores que mais influenciaram negativamente esse acesso foram maior faixa etária, menor renda, menor escolaridade, não ter plano de saúde e referir uma autoavaliação de saúde muito ruim. O acesso à insulina, por sua vez, se deu com maior frequência via serviço público de saúde (69,7%), e os fatores que mais influenciaram negativamente esse acesso foram raça preta/parda, menor renda, não ter plano de saúde e referir uma autoavaliação de saúde muito ruim. De forma geral, foi evidenciada a importância do PFPB como política de ampliação de acesso a medicamentos essenciais no Brasil, considerando a gratuidade dos anti-hipertensivos e antidiabéticos.

This scoping review provides an analysis of the available experiences on the use of comics to promote the health of school children. It was registered in the Open Science Framework (OSF) under DOI: doi.org/10.17605/OSF.IO/Z5VX6. Seventeen studies were used, including articles, theses and dissertations. The results present the main characteristics of the studies such as year; country; sample characteristics; study design; description of actions and population/sample. The target population of each selected study was children younger than 10 years. The sample number of the studies ranged between 47 and 881 children. Fifteen studies developed the interventions in schools. 44.4% of the selected studies were published between 2011 and 2020, and the continents with the highest number of publications were South America and North America, with 33.3% each. Regarding the type of study, 55.6% used the non-randomized experimental method and 35.3% had themes related to specific diseases. The experiences that were considered successful were conditioned to the organizational structure of the use of comic books and how they were offered to school children.

The aim of this research was to evaluate the incidence of congenital syphilis and the ratio between congenital syphilis and syphilis in pregnant women in Brazil according to socioeconomic indicators (inadequate water supply and sanitation; illiteracy at 15 years of age or older; household income per capita; proportion of poor people; Gini index; human development index; and average health expenditure per inhabitant by the health system) and prenatal quality-of-care indicators. We conducted an ecological study using a sample composed of 257 municipalities, each with ≥ 100,000 inhabitants. Data was collected from four public databases: the Brazilian Institute of Geography and Statistics, comprising socioeconomical data from the 2010 census; and the data of 2019 available in the databases of the Department of Informatics of the Brazilian Health System, Information and Management of Primary Care, and the Electronic Citizen Information System. Descriptive analysis of dependent and independent variables and bivariate analysis by Negative Binomial regression were carried out. The mean incidence of congenital syphilis was 38% higher in municipalities with a Human Development Index up to 0.785 (ratio of means [RM] = 1.38; p = 0.049) and 57% higher among populations where less than 50% of primary healthcare services provided a rapid test for syphilis (RM = 1.57; p < 0.001). The ratio between congenital syphilis and syphilis in pregnant women was 29% higher in municipalities with a low household income per capita (RM = 1.29; p < 0.001) and 28% higher in locations where less than 50% of the primary healthcare services provided a rapid test for syphilis (RM = 1.28; p < 0.001). There was no statistical significance of the quality of prenatal care compared to the outcomes. This result underscores the challenges in detecting syphilis infections among pregnant women during prenatal care, consequently increasing the risk of vertical transmission of the disease to the fetus. Traits of inequality in the occurrence of congenital syphilis also draw attention to strategies to reduce health inequities and improve prenatal care.

To analyze the efficacy and psychometric properties of the Knowledge, Attitudes, and Practices Questionnaire when applied to adolescents. It was a cross-sectional construct validation study. Ten questions on the knowledge of HIV/AIDS were selected from the questionnaire for further data analysis and applied to 623 adolescents attending high school. The Statistical Package for the Social Sciences (SPSS) 25.0™ and Stata 14.0 software processed the data. Cronbach's Alpha verified the reliability of items, and the mean of each value ranged from 0.198 to 0.379. Factor analysis assessed the structure of correlations between variables. The resulting factors were lifestyle/habits, preventive actions, and endogenous and exogenous transmission. The scale was reliable for the studied population, ensuring the quality of the instrument.

IntroductionAccess to medicines is a challenge, especially in developing countries, highlighting the need of population-based research to evaluate access and related factors.ObjectiveThis study aimed to assess access to medicines and identify associated factors using data from the 2019 Brazilian National Health Survey (PNS).MethodsThis population-based cross-sectional study used data from the 2019 PNS and considered access to prescription medicines as the primary outcome. The sample included 24,753 individuals aged 15 years or older who looked for medical care in the last 15 days and received a medicine prescription. Andersen's behavioral model was used to select independent variables. After descriptive analysis, a multinomial logistic regression multilevel analysis was performed using the independent variables with a significance level lower than 0.20 in the bivariate analysis.ResultsThe lowest chances of getting access to medicines were observed in individuals aged between 40 and 59 years, women, with complete middle and high school, with lower-income families, who attended public services, with worse self-assessed health, and those who looked for health care for disease prevention and health promotion.ConclusionsAccess to medicines among the Brazilian population is associated with social, economic, and health perception factors. Our findings may update and guide the development of public policies on medication and pharmaceutical care, facilitating medication purchases by the care user and promoting health equity.

Understanding individual perception of Quality of Life (QoL) can help combat social and health inequalities. We aimed to identify factors associated with Low Perceived Quality of Life (LPQoL) in 295 adults and older adults with food security and food insecurity, in the city of Natal, Brazil. A cross-sectional study was conducted from June to December 2019, with collection of data on socioeconomic demographic status, lifestyle information, non-communicable diseases (NCDs) and risk factors, emotional disorders, food (in) security and quality of life. To assess food insecurity, the Brazilian Scale of Food Insecurity—EBIA was used, and the WHOQOL-Bref questionnaire was used to assess quality of life. Poisson's Regression was used to verify associations between variables and LPQoL, stratifying the sample into food secure (FS) and food insecure (FI) groups. In the FI group, being overweight, older adult, having no partner, drinking alcoholic beverages twice a week or more, and not having daily availability of water were associated with LPQoL, and in the FS group, having diabetes, monthly family income in the 1st and 2nd tertiles, and never having studied was associated with LPQoL. Reporting emotional disorders and sleeping < 7 h/day were associated with LPQoL in both FI and FS groups. LPQoL was associated with the occurrence of NCDs and risk factors, and emotional disorders, regardless of the food security measure. However, the lack of adequate access to water highlights the social vulnerability of the FI group.

Knowledge on the occurrence of multimorbidity is important from the viewpoint of public policies, as this condition increases the consumption of medicines as well as the utilization and expenses of health services, affecting life quality of the population. The objective of this study was to estimate prevalence of self-reported multimorbidity in Brazilian adults (≥18 years old) according to socioeconomic and demographic characteristics. A descriptive study is presented herein, based on data from the National Health Survey, which was a household-based survey carried out in Brazil in 2013. Data on 60,202 adult participants over the age of 18 were included. Prevalences and its respective confidence intervals (95%) were estimated according to sex, age, education level, marital status, self-reported skin color, area of residence, occupation and federative units (states). Poisson regression models univariate and multivariate were used to evaluate the association between socioeconomic and demographic variables with multimorbidity. To observe the combinations of chronic conditions the most common groups in pairs, trios, quartets and quintets of chronic diseases were observed. The prevalence of multimorbidity was 23.6% and was higher among women, in individuals over 60 years of age, people with low educational levels, people living with partner, in urban areas and among unemployed persons. The states of the South and Southeast regions presented higher prevalence. The most common groups of chronic diseases were metabolic and musculoskeletal diseases. The results demonstrated high prevalence of multimorbidity in Brazil. The study also revealed that a considerable share of the economically active population presented two or more chronic diseases. Data of this research indicated that socioeconomic and demographic aspects must be considered during the planning of health services and development of prevention and treatment strategies for chronic diseases, and consequently, multimorbidity.

The aim of this study was to associate minor psychiatric disorders (general health) and quality of life with temporomandibular disorders (TMD) in patients diagnosed with different TMD classifications and subclassifications with varying levels of severity. Among 150 patients reporting TMD symptoms, 43 were included in the present study. Fonseca's anamnestic index was used for initial screening while axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD) was used for TMD diagnosis (muscle-related, joint-related or muscle and joint-related). Minor psychiatric disorders were evaluated through the General Health Questionnaire (GHQ) and quality of life was assessed using the World Health Organization Quality Of Life-Brief Version (WHOQOL-BREF). An association was found between minor psychiatric disorders and TMD severity, except for stress. A stronger association was found with mild TMD. Considering TMD classifications and severity together, only the item "death wish" from the GHQ was related to severe muscle-related TMD (p = 0.049). For quality of life, an association was found between disc displacement with reduction and social domain (p = 0.01). Physical domains were associated with TMD classifications and severity and the association was stronger for muscle and joint-related TMD (p = 0.37) and mild TMD (p = 0.042). It was concluded that patients with TMD require multiple focuses of attention since psychological indicators of general health and quality of life are likely associated with dysfunction.

The use of clinical indicators of satisfaction (OHIP) can be applied to evaluate the impact of denture use on patient quality of life, since dental problems and disorders interfere in the normal life of individuals. Aim: This study aimed at evaluating the satisfaction level of patients rehabilitated with removable partial dentures (RPD) after 2 years of use. Methods: An observational study was carried out on 28 patients with a mean age of 45 years, treated with RPD at the Department of Dentistry of the Federal University of Rio Grande do Norte in 2005. Patients signed informed consent and answered the Oral Health Impact Profile (OHIP) questionnaire on three occasions: prior to rehabilitation and at 3 months and 2 years of denture use. Repeated-measures ANOVA was applied for data analysis. Results: A difference was found between data obtained at the moment of fitting and three months after denture use (p0.05). The variables of gender and age did not interfere in the result (p>0.05). Conclusions: The degree of patient satisfaction after RPD installation was significant at the moment of fitting and 3 months after denture use, but no significant difference was found between 3 months and 2 years of denture use.

The aim of this study was to investigate the prevalence of orofacial clefts in live newborns from 1998 to 2002 in Brazilian state capitals and correlate their occurrence with a number of relevant socioeconomic factors collected in the 2000 census. Data was obtained from the Public Health Hospital Information System (SIH-SUS), Information System of Live Hospital Births (SINASC) and Atlases of Human Development in Brazil. The results showed that the mean prevalence of orofacial clefts in Brazil was 0.36 per 1,000 live births. Using Pearson's correlation coefficient, the correlation between cleft rate and social factors was not statistically significant (p > 0.05). Our study suggests that there is no correlation between the municipal economic factors and the prevalence of orofacial clefts, which is likely influenced by underrecording problems in the less developed municipalities.

As doenças crônico-degenerativas representam um grande problema de saúde pública, necessitando de levantamento e controle mais efetivos destas enfermidades por parte dos órgãos públicos. O objetivo deste estudo foi correlacionar os índices de mortalidade por câncer oral nas capitais do Brasil no período de 1998 a 2002 com indicadores sócio-econômicos do Censo Demográfico de 2000, por meio de um estudo do tipo ecológico. Os dados foram extraídos do Sistema de Informação de Mortalidade (Ministério da Saúde/DATASUS), para os anos de 1998-2002. Os indicadores sócio-econômicos foram obtidos a partir do Atlas do Desenvolvimento Humano no Brasil. Após coleta dos dados, a análise estatística foi realizada usando-se o índice de correlação de Pearson. Observaram-se correlações positivas e significativas entre os indicadores sócio-econômicos (Índice de Desenvolvimento Humano-Municipal - IDH-M, IDH-M renda, IDH-M educação, IDH-M longevidade e renda per capita), e correlação negativa e significante para os indicadores sócio-econômicos índice de Gini e mortalidade infantil. Apesar das limitações do estudo e da provável problemática de sub-registros nas capitais menos desenvolvidas, o presente trabalho encontrou correlações estatisticamente significantes entre os indicadores sócio-econômicos selecionados e o índice de mortalidade por câncer oral.Chronic non-communicable diseases represent a major public health problem, requiring more effective investigation and control by government agencies. The aim of this study was to correlate the mortality rate for oral cancer in Brazilian State capitals from 1998 to 2002 with socioeconomic factors collected in the 2000 census, using an ecological study design. Data were obtained from the Mortality Information System from 1998 to 2002. Social factors were taken from the Brazilian Human Development Atlases. After data collection, statistical analysis was performed using Pearson's correlation index. The findings included positive and significant correlations among the socioeconomic indicators (Municipal Human Development Index - MHDI, MHDI-income, MHDI-education, MHDI-life expectancy, and per capita income), and negative and significant correlations with the socioeconomic indicators Gini Index and infant mortality. Despite the study's limitations and probable underreporting in less developed State capitals, the study found significant statistic correlations between the selected socioeconomic indicators and the oral cancer mortality rate.

Introduction: Combination Syndrome (CS) is a pathological condition observed in maxillary complete denture (CD) and mandibular removable partial denture (RPD) wearers. Purpose: The aim of this study was to observe and measure the prevalence of CS signs in treatment-seeking wearers of maxillary CD associated or not with RPD (mandibular Kennedy Class I). The association between RPD wearing and the number of CS clinical signs was also evaluated. Material and method: The sample included 62 patients seen at the Department of Dentistry, Federal University of Rio Grande do Norte (UFRN). A clinical oral examination was conducted to assess the presence of specific clinical signs of CS as described by Kelly (1972): bone resorption in the maxillary anterior region, tuberosity overgrowth, palatal papillary hyperplasia, extrusion of mandibular anterior teeth and bone resorption in the mandibular posterior region. The chi-square test at the 95% level of significance was used to test the association between dependent and independent variables. Result: Mandibular resorption was the most frequent complication (93.5%). There was a statistically significant difference between RPD wearers and non-wearers with regard to extrusion of mandibular anterior teeth (p = 0.045). Conclusion: Within the limitations of the present study, a high prevalence of CS clinical signs was observed, but no association between RPD wearing and syndrome characteristics was found.

RESUMO Este artigo busca elucidar interfaces entre os campos da saúde coletiva e da ecologia política, evidenciando a discussão sobre a vulnerabilização, o território e o metabolismo social, mediante análise crítica da literatura. A ecologia política tem desenvolvido conceitos e metodologias que buscam captar a relação entre economia e conflitos socioecológicos e uma nova racionalidade ambiental. Assim, seu diálogo com a saúde coletiva e o eixo da saúde ambiental permite o aprofundamento teórico sobre os modelos de desenvolvimento econômico e os conflitos socioambientais, além da reflexão sobre estratégias para a descolonização do conhecimento, a reinvenção de territórios e a reapropriação da natureza.

The aim of this research was to evaluate the incidence of congenital syphilis and the ratio between congenital syphilis and syphilis in pregnant women in Brazil according to socioeconomic indicators (inadequate water supply and sanitation; illiteracy at 15 years of age or older; household income per capita; proportion of poor people; Gini index; human development index; and average health expenditure per inhabitant by the health system) and prenatal quality-of-care indicators. We conducted an ecological study using a sample composed of 257 municipalities, each with ≥ 100,000 inhabitants. Data was collected from four public databases: the Brazilian Institute of Geography and Statistics, comprising socioeconomical data from the 2010 census; and the data of 2019 available in the databases of the Department of Informatics of the Brazilian Health System, Information and Management of Primary Care, and the Electronic Citizen Information System. Descriptive analysis of dependent and independent variables and bivariate analysis by Negative Binomial regression were carried out. The mean incidence of congenital syphilis was 38% higher in municipalities with a Human Development Index up to 0.785 (ratio of means [RM] = 1.38; p = 0.049) and 57% higher among populations where less than 50% of primary healthcare services provided a rapid test for syphilis (RM = 1.57; p < 0.001). The ratio between congenital syphilis and syphilis in pregnant women was 29% higher in municipalities with a low household income per capita (RM = 1.29; p < 0.001) and 28% higher in locations where less than 50% of the primary healthcare services provided a rapid test for syphilis (RM = 1.28; p < 0.001). There was no statistical significance of the quality of prenatal care compared to the outcomes. This result underscores the challenges in detecting syphilis infections among pregnant women during prenatal care, consequently increasing the risk of vertical transmission of the disease to the fetus. Traits of inequality in the occurrence of congenital syphilis also draw attention to strategies to reduce health inequities and improve prenatal care. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To study the temporality of hospital admissions due to arterial hypertension and its associated factors. Methods: An ecological study with secondary data on hospital admissions due to essential arterial hypertension – ICD 10, from the Hospital Information System, the Mortality Information System and and the Primary Care Information System, between 2010 and 2015. Descriptive analysis using means, proportions and linear regression. Results: We recorded 493,299 hospitalizations due to arterial hypertension from 2010 to 2015, with an average annual progressive cost decrease of −7.76% and −24.21%. Of the patients admitted, 59.2% were women, 60.2% were non-white and 54.7% were older than 60 years. The mean length of stay was 4.2 days, and the hospitalization cost was R$307.60. The multiple linear regression variables that remained significant were the percentage of admissions due to primary care-sensitive conditions, the per capita income and the City Human Development Index. Conclusion: Hospital admissions due to arterial hypertension have an impact on the percentage of admissions due to primary care- sensitive conditions. Intensifying primary care activities, raising-awareness among professionals to the importance of integrated care, and investing in social development are crucial to change the reality of hypertension in terms of its control and complications.

Abstract Background The EAT-Lancet diet is a diet aimed at promoting population and planetary health from the perspective of sustainable diets in terms of environmental and health aspects. This study aimed to assess the association between adherence to the EAT-Lancet diet and cardiometabolic risk factors among adults and elderly individuals in a capital city in the northeastern region of Brazil. Methods This is an analytical cross-sectional observational study from a population-based sample conducted between 2019 and 2020, involving 398 non-institutionalized adults and elderly people, of both sexes from “Brazilian Usual Consumption Assessment” study (Brazuca-Natal). There was a 38% response rate due to the suspension of data collection due to the covid-19 pandemic, but According to the comparative analysis of socioeconomic and demographic variables between the surveyed and non-surveyed sectors, losses were found to be random (p = 0.135, Little’s MCAR test). Socioeconomic and lifestyle data, anthropometric measurements, and dietary consumption were collected. We used the Planetary Health Diet Index (PHDI) and the Cardiovascular Health Diet Index (CHDI) for cardiovascular health to assess adherence to the diet’s sustainability. The evaluated cardiometabolic parameters included fasting blood glucose, triglycerides, total cholesterol, HDL-C, LDL-C, and systolic and diastolic blood pressure measurements. We also assessed the presence of type 2 diabetes mellitus, arterial hypertension, and dyslipidemia. For the data analyses, sample weights and the effect of the study design were taken into account. Pearson’s chi-square test was used to evaluate the statistical significance of frequencies. Multiple linear regression models assessed the associations between PHDI and CHDI and its components and the cardiometabolic parameters. Results The mean PHDI was 29.4 (95% CI 28.04:30.81), on a total score ranging from 0 to 150 points and the mean CHDI was 32.63 (95% CI 31.50:33.78), on a total score ranging from 0 to 110 points. PHDI showed a significant positive association with the final CHDI score and components of fruits, vegetables, and legumes, and a negative association with Ultra-processed Food (UPF) (p

Abstract Objective This study aimed to map how oral health is addressed within the universal health coverage (UHC). Methods This scoping review followed the Joanna Briggs Institute methodology. Searches included the WHO Library and PubMed, Scopus, Embase, LILACS, and Cochrane databases. Quantitative and qualitative studies were included without publication date and language restrictions. Results A total of 486 studies were retrieved, of which 292 were excluded in the title and abstract screening phase; 121 full-texts were assessed. After the removal of duplicates and unavailable documents, 50 studies were included in the review and categorized according to the level of scientific evidence. Conclusion Few studies discussed oral health within the UHC, mostly because this coverage does not include oral health adequately. When offered, oral health packages are limited and include specific populations. Access and use of oral health services remain guided by economic factors, exposing the theoretical financial protectionism that perpetuates health inequalities.

ABSTRACT The aim of this study was to analyze the validity of self-reported anthropometric measurements (weight and height) for classifying the nutritional status of Brazilian adults and elderly people using data from the 2019 National Health Survey (PNS). The PNS sample is made up of permanent private households from all of Brazil’s federative units and this is a cross-sectional study in which 6,571 records were identified with measured and reported data, with no missing data for one variable being identified when in the presence of another. Validation was carried out with 6,381 data after removing atypical data. The variables used for stratification were: gender, age, race/color, schooling, and income, and the weighted Kappa Coefficient and the Intraclass Correlation Coefficient (ICC) were used to analyze agreement between the nutritional status categories. Accuracy was analyzed based on sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). For construct validity, a Poisson regression was performed for each outcome (measured and self-reported), with the independent variables “gender”, “color/race”, “schooling”, and “family income”. All the analyses showed positive results for validation. There was greater reproducibility among adults (18 to 59 years old) compared to the elderly and among men compared to women. This validation indicates a concrete possibility of carrying out an association of observational studies using reported nutritional status as the outcome variable, as an efficient strategy which could minimize the operational difficulties often encountered.

Objective: Dental students have high levels of anxiety that can affect not only academic performance but also increase the risk for other diseases. It is believed that the increase in the incidence of chronic orofacial pain in temporomandibular disorders (TMDs) may have an impact on the quality of life and general health of subjects. The aim of this study was to evaluate the prevalence of TMD in dental students and its association with general health, quality of life, and anxiety. Method and Materials: Ninety students were evaluated by four questionnaires to determine the prevalence and sever ity of TMD (Fonseca's questionnaire) and to quantify general health (General Health Questionnaire - GHQ), quality of life (World Health Organization Quality of Life - Brief version - WHOQOLbrief) and anxiety levels (State-Trait Anxiety Index - STAI). Results: Approximately 58.9% of dental students presented TMD. Among the indicators of general health, psychologic stress (P = .010), distrust in their own performance (P = .012), and psychosomatic disorders (P = .020) showed a statistically significant difference with the presence of TMD. The four areas proposed in the questionnaire regarding quality of life, such as physical (P = .016), psychologic (P < .001), social (P = .045), and environmental (P = .017) factors also showed significant differences with the presence of TMD. Conclusion: A high prevalence of TMD was observed in dental students. In addition, some psychologic domains are important psychosocial indicators associated with the presence of TMDs. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the prevalence of work-related musculoskeletal disorders (WMSD) and their association with individual and contextual factors in the Brazilian population. This quantitative cross-sectional study used secondary data from the Brazilian National Health Survey from August 2013 to February 2014. The dependent variable included WMSD, and independent variables were analyzed as individual and contextual factors. WMSD was mostly prevalent in females, individuals aged 43 to 59 years, with chronic physical or mental disorders, reporting frequent sleep disorders, and performing integrative and complementary health practices, physical exercise or sports, and heavy physical activity or housework. Regarding contextual factors, high social classes and proportion of individuals with formal work were associated with a high prevalence of WMSD, whereas a high Gini index was associated with a low prevalence. Thus, a high prevalence of WMSD in the Brazilian population was associated with individual and contextual factors, which should be the target of health professionals for actions of promotion, prevention, and intervention at individual or collective care levels.

ObjectivesTo assess the prevalence and associated factors of Patellofemoral Pain Syndrome (PFPS) in children and adolescents.MethodA population-based cross-sectional study was conducted with children and adolescents aged 10 to 18 years, who presented a history of peripatellar and/or retropatellar pain, attending elementary or high school in urban public schools in Natal, Brazil. The sample size was calculated based on a minimum outcome prevalence of 22%.ResultsA prevalence of 24.7% of PFPS was found. There was a positive association of PFPS with active students (p < 0.01; PR: 2.5; CI: 1.4-4.5), low functional capacity (p < 0.01; PR: 8.0; CI: 5.0-12.8), and those classified as pubertal (p < 0.03; PR: 1.8; CI: 1.0-3.2).ConclusionThere was a considerable prevalence of PFPS in children and adolescents, as well as an association between the level of sexual maturation and adjustable determinants, such as the level of physical activity and low functional capacity in this group.

Abstract Objective: Food insecurity (FI) is the lack of daily access for everyone to quality food in sufficient quantity. In many populations, it presents as a chronic and persistent condition. This study analysed the association between the length of time living with FI and socio-demographic conditions in households in a semi-arid municipality in the Brazilian Northeast between 2011 and 2019. Design: This is a population-based cohort study among families in the municipality in Northeast Brazil (2011, 2014 and 2019). FI was estimated through the Escala Brasileira de Insegurança Alimentar (EBIA, Brazilian Household Food Insecurity Measurement Scale), and the longitudinal category of time of living with FI was adopted to classify them according to the time they remained in FI during the cohort. The association with the socio-demographic profiles of the population was verified through multinomial logistic regression. Setting: Households in semi-arid, Northeast of Brazil. Participants: Household respondents interviewed in 2011, 2014 and 2019 (n 274). Results: Sixty-seven percentage (67 %) of families lived in FI in this period. Rural residence, low monthly per capita income and low schooling of the household reference person increased the chances of these families living longer in FI. These overlapping conditions increased the odds of FI in the household. Conclusions: Coping with FI requires intersectoral intervention that improves the socio-demographic conditions of the population.