Opinion – Marcia Castro: There is alert, lack of action

Since 2006, Brazil has carried out Vigitel, an annual telephone survey that interviews adults aged 18 and over in the capitals of the 26 Brazilian states and in the Federal District. Vigitel is one of the surveys that make up the Surveillance System for Risk and Protection Factors for Non-Communicable Chronic Diseases.

Vigitel’s 2021 report, released in April, showed that 11.3% of adults had a diagnosis of depression. According to the National Health Survey, this percentage was 10.2% in 2019 and 7.6% in 2013. The situation is worse among women with less education, and among adults over 45 years of age. A survey of pregnant women in Fortaleza during the lockdown period in May 2020 revealed that 45.7% had depressive symptoms. Also worrying is the prevalence of depression and anxiety among children and adolescents, around 25% between 2020 and 2021. The Covid-19 pandemic certainly contributed to this worsening. Prejudice, misinformation and inequity in access and quality of treatment are barriers to be overcome.

Vigitel also showed that 60% of men and 55% of women were overweight and about 1 in 5 adults was obese. The numbers are worse among the oldest and those with less education. It is worth remembering that obesity increases the risk of serious cases and death from Covid-19, and was recently identified as one of the factors that delay the recovery of patients suffering from Covid-19.

The prevalence of overweight and obesity in Brazil has consistently increased over the years. In 2006, when the first survey was carried out, about 1 in 10 adults was obese, and 43% were overweight. Here, three points are important.

First, about 39% of men and 56% of women did not report a sufficient level of physical activity, while 16% of adults were physically inactive. Again, the situation is worse among those with fewer years of education.

Second, the pattern of food consumption is not ideal. Only 17% of men and 26% of women consumed five or more daily servings of fruits and vegetables, while 22% of men and 15% of women reported consuming five or more groups of ultra-processed foods. Younger people reported higher consumption of ultra-processed foods, 28% among people aged between 18 and 24 years.

Third, about 26% of adults in 2021 had already received a medical diagnosis of high blood pressure and 9% had a diagnosis of diabetes. These percentages were much higher among adults aged 65 and over (61% with hypertension and 28% with diabetes) and among those with 8 years or less of schooling (45% with hypertension and 18% with diabetes).

This context of insufficient physical activity and precarious food consumption contributes to the upward trend in overweight and obesity, which in turn worsens the prevalence of diabetes and hypertension. The worsening of this context has already been shown by Vigitel and other surveys over the years.

With the recent increase in inequalities and the aging of the population in progress, the increase in the future burden of chronic diseases and the worsening of the context presented here are likely unless there are concrete and immediate actions. The demand for medical care and procedures as a result of this worsening may exceed the response capacity of the health system.

There is data, the warning has long been given, and the window of opportunity to act is getting smaller every day. May the presidential candidates present their plans to reverse this trend and ensure a healthy life with equity for the Brazilian population.