Brazilians with less education more likely to report being in poor health, study finds

May 16, 2018, University of Illinois at Urbana-Champaign
The study found that people in Brazil with less education were more likely to identify themselves as being in poor health. The data pictured are from the Brazil National Health Survey 2013. Credit: Julie McMahon, University of Illinois

Brazilians with less education are more likely to self-report as being in poor health, according to a study using data from nationwide surveys distributed every five years from 1998 to 2013. The study also found that general subjective health did not improve over the study period, even though more people gained education throughout the study, indicating that other factors associated with poor education may need to be addressed to improve self-perceptions of health.

University of Illinois researchers Flavia Cristina Drumond Andrade, a professor of kinesiology and community , and Jeenal Deepak Mehta, an undergraduate student, published the study in the journal PLOS ONE.

"Self-reported perceived health is an effective health indicator that has been shown to be a good predictor of mortality," Andrade said. "In social contexts such as developing countries, in which some diseases may go unnoticed or undiagnosed for a while, survey data can give a good sense of individuals' assessment of their overall health."

Andrade and Mehta used data from the 1998, 2003 and 2008 Brazilian National Household Sample Survey and the Brazil National Health Survey 2013. The surveys included many factors, such as levels, employment, race, location and health. Participants reported themselves as being in "good" or "poor" health.

Overall, the percentage of those who reported themselves as being in poor health was fairly small—the highest being 5.9 percent in 2013. However, when the researchers separated the respondents by education level, they found that the less education a group had, the higher the percentage of self-reported poor health.

The gradient was sharp, and consistent across all years of the survey: Those with no education were seven to nine times more likely to report poor health than those with at least some college.

"Often, those with lower education experience worse employment—with lower wages, worse working conditions and less access to health care—than those with more education," Andrade said. "They may also engage in unhealthy lifestyle behaviors, in part due to lower health knowledge and in part due to economic restrictions. All these conditions put them in relative disadvantage, which could be translated as worse perceived health."

Over the course of the surveyed years, Brazil experienced a period of educational development, Andrade said. The percentage of those who had completed high school rose from 13.9 percent in 1998 to 28.6 percent in 2013, and the percentage of those with some college or more rose from 9 percent to 19.1 percent. Yet the overall percentage of self-reported has not varied largely, and even rose a bit in 2013, although education levels rose.

Again, the researchers noticed a difference in health reporting over time according to education levels.

"There was a worsening of self-reported perceived health among those with primary or secondary education. This is important because most Brazilians are in this group—74.8 percent in 1998 and 68 percent in 2013. On the other hand, we do not see this pattern among those with some college or more. For them, the levels of poor self-reported health did not change."

The researchers posit that these changes may be related to the slowing of economic growth that Brazil experienced over the last two survey cycles.

"Those with less education often suffer with lower incomes and more during these economic decelerations. When relative conditions worsen, perceptions of health and well-being also tend to get worse among those at the bottom of the social scale," Andrade said.

In addition, Andrade urges those seeking to improve general health in Brazil to address not only education but also the aging of the population—the average age of the respondents increased from 40 to 44 years over the study period—and the prevalence of chronic conditions, such as diabetes, that were reported on the surveys.

"With increases in age, there are also increases in poor self-perceived health," Andrade said. "Along with the demographic transition, there were also increases in the prevalence of some chronic conditions, which also impacts the perception of health. Therefore, efforts to prevent and control chronic conditions are necessary to improve self-perceptions of health in Brazil."

Explore further: An unexpected side effect of public health education efforts in Brazil

More information: Flavia Cristina Drumond Andrade et al, Increasing educational inequalities in self-rated health in Brazil, 1998-2013, PLOS ONE (2018). DOI: 10.1371/journal.pone.0196494

Related Stories

An unexpected side effect of public health education efforts in Brazil

March 21, 2018
Understanding of tuberculosis is associated with higher, not lower, stigmatization of TB patients in Brazil, according to a new "Insights" report from Vanderbilt's Latin American Public Opinion Project (LAPOP) titled "Blaming ...

Young men who have sex with men receive less HIV education

January 22, 2018
Young men who have sex with men (MSM) are at much higher risk of HIV infection compared to their peers, but a new study led by a Boston University School of Public Health (BUSPH) researcher suggests young MSM are less likely ...

When it comes to your health, where you live matters

January 23, 2018
According to a recent report, Alabama, Arkansas, Louisiana, Mississippi and West Virginia have the worst health in the U.S. These states have higher rates of premature deaths, chronic diseases and poor health behaviors year ...

During 2013 to 2016, 8.1 percent of U.S. adults had depression

February 14, 2018
(HealthDay)—During 2013 to 2016, 8.1 percent of American adults aged 20 years and older had depression in a given two-week period, according to a February data brief published by the U.S. Centers for Disease Control and ...

Amenable death in Europe: Health care expenditure decreases mortality rates

June 5, 2017
The June issue of Health Affairs includes an analysis of amenable mortality rates—rates of deaths that are potentially preventable with available health care treatment options—in seventeen European countries, which found ...

Recommended for you

Crunched for time? High-intensity exercise = same cell benefits in fewer minutes

September 20, 2018
A few minutes of high-intensity interval or sprinting exercise may be as effective as much longer exercise sessions in spurring beneficial improvements in mitochondrial function, according to new research. The small study ...

China's doctor shortage prompts rush for AI health care

September 20, 2018
Qu Jianguo, 64, had a futuristic medical visit in Shanghai as he put his wrist through an automated pulse-taking machine and received the result within two minutes on a mobile phone—without a doctor present.

Time to ban the sale of energy drinks to children, says senior doctor

September 19, 2018
It's time to bring in laws to ban the sale of caffeinated energy drinks to children and young people in England to tackle the twin epidemics of obesity and mental health problems, argues Professor Russell Viner, President ...

For-profit hospitals correlated with higher readmission rates

September 19, 2018
Patients who receive care in a for-profit hospital are more likely to be readmitted than those who receive care in nonprofit or public hospitals, according to a new study published by University of Illinois at Chicago researchers.

Sugar content of most supermarket yogurts well above recommended threshold

September 18, 2018
A comprehensive survey of ingredients in yogurts highlights high sugar levels in many—particularly organic yogurts and those marketed towards children.

Research confronts 'yucky' attitudes about genetically engineered foods

September 18, 2018
Is a non-browning apple less "natural" than non-fat milk? In one case, people have injected something into apple DNA to prevent it from turning brown after it's cut. In the other, people used technology to remove something ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.