Smoking is declining in Brazil, yet the consumption of alcohol has been increasing, especially among women. This is unveiled by the 4th volume of the National Survey of Health - PNS 2019, on the perception of health condition, lifestyle, chronic diseases and oral health. The survey, carried out in partnership with the Ministry of Health, also includes data on eating habits, physical activities, diabetes and depression.

Among the population aged 18 years and over in 2019, the predominance of users of tobacco products, either smoked or not smoked, used either daily or occasionally, was 12.8% (20.4 million persons) against 14.9% in 2013.

In 2019, 26.4% of the population aged 18 years and over used to consume alcoholic beverages once or more times per week, which represented an increase of 2.5 percentage points in relation to 2013, when this percentage was 23.9%.

In 2019, the proportion of men who used to consume alcoholic beverages at least once per week was 37.1% higher than that reported among women (17.0%). The proportion of women who consumed alcoholic beverages once or more times per week rose 4.1 percentage points over 2013 (12.9%), whereas the percentage of men remained virtually stable (36.3%).

In 2019, 7.2 million persons drove after drinking

Among the persons who drove cars or motorcycles, the PNS estimated the proportion of individuals who drove after consuming alcoholic beverages. This percentage was 17.0% for Brazil, the equivalent to 7.2 million persons. These rates were higher among men (20.5%) than among women (7.8%).

In regional terms, the proportion varied from 14.8% in the South to 23.4% in the North. The act of driving cars or motorcycles after drinking alcoholic beverages was more frequent in the rural area (22.5%) than in the urban one (16.2%). Among the age groups, this habit prevailed among the drivers aged between 25 and 39 years (21.2%) and the lowest proportion was that of the elderly persons (aged 60 years and over, 11.0%).

Self-assessment of health of Brazilians remains either "good" or "very good"

According to the PNS, Brazil counted with 159.1 million persons aged 18 years and over in 2019. Of them, 66.1% self assessed their health as either good or very good – a percentage similar to that reported in 2013 (66.2%). On the other hand, 28.1% assessed their health condition as regular in 2019 and 5.8%, as either poor or very poor.

The highest percentage of either good or very good (71.9%) was in the the South Region and the lowest one (56.7%), in the Northeast.

Men self assessed their health more positively than women: 70.4% of men considered their health as either good or very good, against 62.3% of women. Concerning the age groups, the bigger the age range, the lower the percentage of persons who assessed their health as either good or very good.

Urban area consumes two times more ultra-processed food than the rural one

According to the recommendation of the Dietary Guidelines for the Brazilian Population 2014, the PNS 2019 began to investigate the consumption of ultra-processed food, in addition to the healthy and non-healthy food indicators already monitored. The proportion of persons who consumed five or more groups of ultra-processed food was 14.3%. Persons living in rural areas registered a lower percentage (7.4%) in relation to those living in urban areas (15.4%).

In contrast, the percentage of persons aged 18 years and over who followed the recommended consumption of fruits and vegetables was 13.0% – varying from 9.0% in the Northeast Region to 16.0% in the Southeast. Women (15.4%), on average, consumed more this food than men (10.2%). In general, the consumption of fruits and vegetables increased with age and schooling level.

In 2019, 46.6% of the population consumed fish at least once a week. In the North Region, the habit of consuming this food is bigger, 74.1%, followed by the Northeast (56.3%). The South Region recorded the lowest proportion of persons with the average consumption of fish once a week, 34.3%.

In the assessment of 12.7% of the persons, the self consumption of salt was high, i.e., it was answered as either high or very high. In the rural area, the percentage was lower (9.0%) than in the urban area (13.3%). And the percentage of women (11.2%) who considered their consumption as either high or very high was lower than that among men (14.5%).

Men practice physical activity in leisure and women, in domestic activities

In the PNS 2019, 34.2% of men aged 18 years and over practiced the recommended level of physical activity in leisure, whereas this percentage was 26.4% for women. In the same period, the Brazilian average was 30.1%. In 2013, this average was 22.7%, whereas the percentages of men and women were 27.3% and 18.6%, respectively.

Of the adult population, 40.3% were classified as insufficiently active – i.e., persons who either did not practice any physical activity or practiced less than 150 minutes per week considering the three domains: leisure; work and commuting.

In Brazil, 42.6% of the persons aged 18 years and over where physically active in their jobs. Among the adults who lived in the urban area, 40.1% practiced 150 minutes of activities in their jobs and, among those living in the rural area, they were 60.0%. The frequency of men for this domain was of 49.2%, whereas that of women was of 34.4%.

Among the white persons, 28.6% practiced 30 daily minutes of physical activity in the commuting. Among the black persons, this frequency was of 38.9% and, among brown persons, 32.8%.

In the domain of the domestic activities, the PNS estimated that 15.8% of the persons aged 18 years and over practiced physical activity at least 150 minutes per week, like heavy cleaning or activities that require an intense physical effort. This indicator was strongly concentrated on the female population, in which 21.8% practiced 150 minutes of physical activity in domestic tasks, whereas it was 9.1% in the male population.

23.9% of the adults were hypertensive in Brazil

The PNS 2019 estimated that slightly more than half (52.0%) of the population aged 18 years and over had been diagnosed with at least one of the chronic diseases investigated by this survey edition. Nearly 23.9% of the population within this age group (or 38.1 million persons) were diagnosed with high blood pressure, a figure slightly higher than that reported by the PNS 2013 (21.4%).

Among the hypertensive persons, 72.2% stated to have received medical care for the disease in the 12-month period before the interview in 2019. The occurrence of this diagnosis increased with age: in the age group between 18 and 29 years, only 2.8% were hypertensive, though this proportion increased to 62.1% among the population aged 75 years and over.

Diabetes already hits 7.7% of the adult population

The PNS 2019 estimated that 7.7% of the population aged 18 years and over were diagnosed with diabetes, the equivalent to 12.3 million persons. The occurrence was of 6.2% in 2013.

Women (8.4%) were more diagnosed with diabetes than men (6.9%). Basic Health Units were the major place where persons received medical care for diabetes (49.6%), followed by private doctor´s offices or private outpatient clinics (30.0%).

According to the study, 14.6% of the persons aged 18 years and over (23.2 million) were diagnosed with high cholesterol (in 2013, they were 12.5%). The proportion estimated in the urban area was 15.0% and, in the rural area, 12.1%. Women posted a higher proportion of diagnoses of high cholesterol (17.6%) than men (11.1%).

8.4 million adults were diagnosed with heart diseases

Nearly 8.4 million persons aged 18 years and over (or 5.3% of this age group) were diagnosed with any heart disease. This proportion was higher in the urban area (5.4%) than in the rural area (4.4%). It was noticed that 29.1% of the persons diagnosed with any heart disease had already been submitted to a surgery of saphenous graft, introduction of stents or angioplasty.

The PNS unveiled that 5.3% of the persons aged 18 years and over were diagnosed with asthma (or asthmatic bronchitis) in Brazil (8.4 million persons). This indicator was 5.5% in the urban area, whereas it was 3.8% in the rural area. The regional figures were similar to the national one: 4.5% in the North, 5.9% in the Southeast, 6.2% in the South, 5.0% in the Central-West and 4.0% in the Northeast.

Among the adult population, 2.0% reported a diagnosis of stroke, representing nearly 3.1 million persons aged 18 years and over. The results did not show any significant difference by Major Region, varying from 1.8% in the South to 2.1% in the Northeast – nor according to the urban or rural status. The proportion of persons diagnosed with stroke increased as the age increased, varying from 0.3% among persons aged between 18 and 29 years to 9.5% among persons aged 75 years and over.

One of five adults have back injuries

In 2019, nearly 21.6% of the persons aged 18 years and over (34.3 million) reported chronic back injuries in Brazil (in 2013, 18.5%). Unlike the other chronic diseases investigated by the survey, this indicator was lower in the urban area than in the rural area, with percentages of 21.2% and 23.7%, respectively.

In Brazil, 2.5% of the adults were diagnosed with Work-Related Musculoskeletal Disorders - WMSD. The proportion in the urban area was 2.7%, whereas the percentage was 1.2% in the rural area. The highest proportions were registered in the Southeast (3.6%) and South (2.4%). The predominance among women (3.2%) was higher than among men (1.7%).

Brazil has 16.3 million persons diagnosed with depression

In 2019, the PNS estimated that 10.2% of the population aged 18 years and over were diagnosed with depression by mental health professionals. This percentage was higher that that reported by the PNS 2013 (7.6%) and represented 16.3 million persons. The occurrence in urban areas (10.7%) was higher than in rural areas (7.6%). The South and Southeast regions recorded the highest percentages of persons with depression, above the national percentage: 15.2% and 11.5%, respectively.

Among the persons diagnosed with depression, 18.9% did psychotherapy and 48.0% used medicines for the disease over the last two weeks before the survey. This disease prevailed among women (14.7%), against 5.1% of men. The age range with the highest proportion was that between 60 and 64 years (13.2%), while the lowest percentage was obtained in that between 18 and 29 years (5.9%).

It also prevailed in persons with extreme schooling levels, i.e., persons with complete higher education (12.2%) and persons without education or with incomplete primary education (10.9%).

A higher proportion of white persons was diagnosed with depression (12.5%). The proportion was 8.6% among brown persons and 8.2% among black persons. Less than half of men (43.8%) and women (49.3%) who reported a diagnosis of depression used medicines for depression. The average proportion in Brazil was 48.0%.

More than 4 million adults were diagnosed with cancer

In 2019, the National Survey of Health estimated that 2.6% of the persons aged 18 years and over (4.1 million adults) reported a cancer diagnosis in Brazil (in 2013, 1.8%). The proportion in the urban area was significantly higher than in the rural area: 2.7% and 1.7%, respectively. The South Region posted the highest percentage of cancer diagnoses , 3.5%, followed by the Southeast (3.0%) and Central-West (2.4%) regions. The North and Northeast regions, on their turn, registered the lowest occurrence, corresponding to 1.3% and 1.8%, respectively.

The PNS estimated that, among persons aged 18 years and over, 1.5% reported a diagnosis of chronic renal failure. The persons in the age group between 18 and 29 years registered the lowest occurrences of the disease (0.7%) and in the range of 75 years and over recorded the highest proportion (3.1%). Concerning the most intensive cases, 7.3% of the persons aged 18 years and over who reported a diagnosis of chronic renal failure did haemodialysis/dialysis.

Care with oral health increases

In 2019, the proportion of persons aged 18 years and over who brushed their teeth at least two times a day (93.6%) increased in relation to 2013 (89.1%). On the other hand, the proportion of adults who used toothbrush, toothpaste and dental floss to clean their teeth was 63.0%. It was 57.6% among men and 67.7% among women.

Of the persons aged 18 years and over, 50.7% changed their toothbrush for a new one with less than three months of use. This habit was more frequent among the younger than among the older, as well as among the persons with higher schooling level.

In 2019, 69.7% of the persons aged 18 and over evaluated their oral health as either good or very good.  The estimates varied from 62.2% in the Northeast to 74.3% in the South.  The PNS 2019 estimated that 78.2 million persons aged 18 years and over had consulted the dentist over the 12-month period before the interview date.

Virtually one out of three adults (33.0%) used some type of dental prosthesis (33.4% in 2013). Although women revealed a better prevention to oral health, they lost more teeth and used more dental prostheses in 2019 (37.1% against 28.4% among men).