BACKGROUND:Cancer represents one of the leading global public health challenges, with its burden shaped not only by biological factors but also by social and economic inequalities. In Brazil, even municipalities with a very high Human Development Index (HDI) exhibit persistent disparities. This study assessed temporal changes in cancer incidence, mortality, and social inequalities in Campinas, São Paulo State, Brazil. METHODS:A repeated cross-sectional study was conducted using incidence and mortality rates of the most frequent neoplasms among men and women residing in Campinas, SP, Brazil from 2010 to 2014 and 2015-2019 from the Population-Based Cancer Registry and the Mortality Information System. Age-standardized incidence and mortality rates were estimated for the most common cancers, stratified by levels of social vulnerability based on the São Paulo Social Vulnerability Index. Inequalities were analyzed using the Relative Index of Inequality (RII). RESULTS:Among men, prostate cancer (RR= 0.94; 95% CI: 0.89-0.99) and stomach cancer (RR= 0.82; 95% CI: 0.72-0.93) incidence declined, while mortality remained stable for most cancers, except for an increase in colorectal cancer mortality (RR 1.15; 95% CI: 1.00-1.32 - p = 0.032 and a reduction in stomach cancer mortality (RR= 0.83; 95% CI: 0.66-1.04). Socially vulnerable men showed persistently higher mortality from prostate, stomach, and oral cavity cancers. Among women, breast cancer incidence increased (RR= 1.14; 95% CI: 1.08-1.20), and overall mortality rose (RR= 1.06; 95% CI: 1.01-1.12), particularly from lung cancer (RR= 1.25; 95% CI: 1.07-1.47). Vulnerable women exhibited consistently higher cervix uteri cancer incidence (2010-2014: RII= 2.90; 95% CI: 1.90-4.43 vs. 2015-2019: RII= 2.36; 95% CI: 1.58-3.53) and mortality (2010-2014: RII= 2.74; 95% CI: 1.42-5.26 vs. 2015-2019: RII= 3.60; 95% CI: 1.89-6.85), while breast cancer incidence remained higher among less vulnerable women (2010-2014: RII= 0.42; 95% CI: 0.37-0.49 vs. 2015-2019: RII= 0.49; 95% CI: 0.43-0.56). Inequalities in colorectal cancer incidence narrowed over time for both sexes; however, mortality inequality among men reversed, becoming higher among the most vulnerable in 2015-2019 (RII= 0.92; 95% CI: 0.66-1.29). CONCLUSION:Despite high socioeconomic development, substantial social inequalities in cancer incidence and mortality persist in Campinas, with some disparities widening over time. These findings highlight the need for targeted and equity-oriented cancer control strategies to improve access to early diagnosis, treatment, and care among socially vulnerable populations.

ABSTRACT Objective: To analyze the prevalence of early detection tests for cervical, breast, prostate, and colorectal cancers in the population of Campinas, São Paulo and the presence of social inequalities in access. Methods: Population-based cross-sectional study using data from ISACamp 2014/15. Dependent variables were the performance of Pap smear, mammogram, prostate-specific antigen (PSA), fecal occult blood test (FOBT) and colonoscopy/sigmoidoscopy within the age ranges recommended by national guidelines. Independent variables included sex, age, schooling, income, race/skin color, and private health insurance. Prevalence and prevalence ratio adjusted for sex and age were estimated using Poisson regression. Analyses were performed using Stata 14, considering sampling weights. Results: The prevalence of mammography (77.7%) and Pap smear (87.8%) met the targets set by the Brazilian Ministry of Health, while FOBT (22.3%) and colonoscopy/sigmoidoscopy (21.5%) showed low coverage. PSA testing in the previous three years was reported by 55.2% of eligible men. Higher prevalence of test performance was observed among individuals with higher schooling and income levels and those with private health insurance. Inequalities varied by type of test. For instance, individuals with private health insurance had 11 and 162% higher prevalence of Pap test and colonoscopy/sigmoidoscopy, respectively, compared to those without insurance. Racial inequality was observed only for mammography. Conclusion: The results indicate high coverage and lower inequalities for Pap and mammography, and low coverage with significant disparities for FOBT and colonoscopy/sigmoidoscopy. Findings highlight the need to monitor coverage and to implement public policies aimed at reducing inequities in access to cancer screening.

There are still contradictions and ambiguities in knowledge about the association of visual, hearing, and physical problems with sex, race, income, and education level. This study estimated the prevalence and trace social, racial and sex inequalities according to the type of impairment: visual, hearing and physical. A cross-sectional, population-based study was conducted with data from 3,021 individuals from ISACamp 2014/15. We estimated the prevalence of the three impairments according to age group, sex, race, income, education and health insurance and the prevalence ratios adjusted, using multiple Poisson regression. It was observed that 15.2% of individuals reported visual impairment, 8.1% hearing and 2.1% physical. Inequality was detected according to education level in persons with visual and physical impairments, gender inequality was observed in cases of physical impairment and racial inequality only in visual impairment. It was possible to understand the profile of persons with impairment considering the underlying social inequalities and providing opportunities for a more adequate design of public policies and health care.

The aim was to investigate survival and risk of death within a ten-year period according to physical functioning and frequency of the feeling of happiness in older people, conducting an analysis of the possible mediating effect of happiness on the association between physical functioning and mortality. A retrospective longitudinal study was conducted with 1,519 older people (≥ 60 years) interviewed for the 2008/2009 Health Survey in Campinas. A linkage was made between the databank of the survey and the Campinas Mortality Information System, with active search for confirmation of deaths and non-deaths from 2008 to 2018. Variables of interest were physical functioning (absence/presence of limitations) and frequency of feeling happiness. Kaplan-Meier survival curves were plotted and Cox regression analysis was performed to estimate hazard ratios (HR). A mediation analysis was also conducted using the Karlson-Holm-Breen (KHB) method. In the adjusted analysis, severe functional limitation (HR = 2.8; 95%CI: 2.0-3.8) and low frequency of happiness (HR = 1.6; 95%CI: 1.3-2.0) increased the risk of death in the period. Low frequency of happiness mediated the association between functioning and mortality by 14%. The results underscore the importance of strategies to maintain physical functioning during aging. Moreover, a greater frequency of the feeling of happiness increased the survival of the population. The findings also show that happiness plays an important mediating role in the association between functioning and mortality in older people.

Migration is a social and demographic phenomenon that influences health by reshaping support networks, access to services, and preventive practices. In Brazil, despite the historical relevance of internal migration, there is a lack of population-based studies addressing its impact on oral health. This study aimed to analyze oral health conditions among migrants aged 10 years and older living in Campinas, São Paulo, with comparisons by sex. A cross-sectional population-based survey was conducted using data from the 2014 to 2015 Campinas Health Survey, which employed a probabilistic two-stage cluster sampling design. The final sample comprised 3,019 individuals. Outcomes included dental loss (partial or total), non-use of prostheses, self-rated poor oral health, reasons for consultations, access to urgent care, and psychosocial indicators, such as embarrassment when smiling and difficulty speaking. Associations between migration status and oral health outcomes were estimated using Rao-Scott chi-square tests and Poisson regression with robust variance, adjusting for age, education, race/skin color, and region of origin, stratified by sex. Migrants had poorer oral health than non-migrants, particularly among men. Male migrants had a higher prevalence of tooth loss, poor self-rated oral health, urgent dental visits, difficulty obtaining urgent care, and negative evaluations of services. They also reported greater difficulty speaking and embarrassment when smiling. No significant associations were found for women after adjustment for confounding factors. Nonetheless, the study provides novel evidence that internal migration in Brazil is associated with poorer oral health outcomes, with notable disadvantages for men. These findings highlight the need for policies that address the specific vulnerabilities of migrant populations in accessing and maintaining oral health care.

ABSTRACT The Brazilian Association of Collective Health (Abrasco) has played a leading role in consolidating collective health in Brazil since its foundation. After 19 years, Abrasco's Epidemiology Committee resumed its planning with the development of the Fifth Strategic Plan for the Development of Epidemiology in Brazil (2025–2029). This plan emerged in a challenging context marked by social inequalities, scientific denialism, the COVID-19 pandemic, the climate crisis, and disinvestment in public policies, reinforcing the need to update Brazilian epidemiology. The plan's development occurred in multiple stages, including online surveys, debates, and in-person workshops. Workshop I (Brasília, 2023) identified priority challenges, and Workshop II (Rio de Janeiro, 2024) defined strategies to address them. The construction process was guided by the qualified participation of epidemiologists from all regions of the country and was based on principles of plurality, diversity, gender equity, and race/ethnicity. The plan highlights epidemiology across three thematic areas: education, research, and health policies, programs, and services. The Strategic Plan Working Group of the Epidemiology Committee, supported by the Secretariat of Health and Environment Surveillance of the Ministry of Health, led the process. This supplement of the Brazilian Journal of Epidemiology presents the Fifth Strategic Plan for the Development of Epidemiology in Brazil (2025–2029), contributions to the discussion of some central topics, and a deepening of strategic and operational dimensions. The Fifth Strategic Plan for the Development of Epidemiology in Brazil (2025–2029) presents a collective vision for the future, aiming to strengthen epidemiology as a central discipline within the field of collective health. It reaffirms its commitment to equity, social justice, and the consolidation of the Sistema Único de Saúde in Brazil.

RESUMO Objetivo: Analisar a prevalência da realização de exames de detecção precoce de câncer do colo uterino, mama, próstata e colorretal na população de Campinas (SP) e a presença de desigualdades sociais no acesso. Métodos: Estudo transversal de base populacional que utilizou dados do Inquérito de Saúde do Município de Campinas 2014/15. As variáveis dependentes foram a realização de Papanicolaou, mamografia, antígeno prostático específico (PSA), sangue oculto nas fezes (SOF) e colonoscopia/sigmoidoscopia, nas faixas etárias recomendadas. As variáveis independentes incluíram sexo, idade, escolaridade, renda, raça/cor da pele e plano de saúde. Estimaram-se prevalências e razões de prevalência ajustadas por sexo e idade, por meio de regressão de Poisson. As análises foram realizadas no Stata 14, considerando-se os pesos amostrais. Resultados: As prevalências de mamografia (77,7%) e Papanicolaou (87,8%) atingiram as metas do Ministério da Saúde, enquanto as de SOF (22,3%) e colonoscopia/sigmoidoscopia (21,5%) foram baixas, e a de PSA nos últimos 3 anos foi de 55,2%. A prevalência de realização dos exames foi maior nos segmentos com maiores escolaridade e renda e com plano de saúde, e as desigualdades variaram conforme o exame. Pessoas com plano de saúde, por exemplo, apresentaram prevalências de Papanicolaou e colonoscopia/sigmoidoscopia, 11 e 162% maiores que as sem plano. Desigualdade por raça/cor foi observada somente na mamografia. Conclusão: Os resultados evidenciaram cobertura elevada e menores desigualdades para Papanicolaou e mamografia e baixa realização com importantes desigualdades para SOF e colonoscopia/sigmoidoscopia. Os achados indicam a importância do monitoramento da cobertura desses exames e a necessidade de políticas públicas que ampliem a equidade no acesso.

Resumo A Associação Brasileira de Saúde Coletiva (Abrasco) tem sido protagonista na consolidação da saúde coletiva no Brasil desde sua fundação. Após 19 anos, a Comissão de Epidemiologia da Abrasco retomou seu planejamento com a elaboração do V Plano Diretor para o Desenvolvimento da Epidemiologia no Brasil (2025–2029). Esse plano surgiu em um contexto desafiador, marcado por desigualdades sociais, negacionismo científico, pandemia de COVID-19, crise climática e desinvestimento em políticas públicas, reforçando a necessidade de atualização da epidemiologia brasileira. A elaboração do plano ocorreu em múltiplas etapas, incluindo inquéritos online, debates e oficinas presenciais. A Oficina I (Brasília, 2023) identificou desafios prioritários, e a Oficina II (Rio de Janeiro, 2024) definiu estratégias de enfrentamento. O processo de construção foi pautado pela participação qualificada de epidemiologistas de todas as regiões do país e fundamentado em princípios de pluralidade, diversidade, equidade de gênero e raça/etnia. O plano destaca a epidemiologia em três áreas temáticas: formação; pesquisa; e políticas, programas e serviços de saúde. O Grupo de Trabalho Plano Diretor da Comissão de Epidemiologia, com apoio da Secretaria de Vigilância em Saúde e Ambiente, do Ministério da Saúde, conduziu o processo. Esse suplemento da Revista Brasileira de Epidemiologia apresenta o V Plano Diretor para o Desenvolvimento da Epidemiologia no Brasil (2025–2029), contribuições para debates de alguns temas centrais e aprofundamento de dimensões estratégicas e operacionais. O V Plano Diretor para o Desenvolvimento da Epidemiologia no Brasil (2025–2029) expressa uma visão coletiva de futuro com vistas ao fortalecimento da epidemiologia enquanto disciplina central no campo da saúde coletiva e reafirma seu compromisso com a equidade, a justiça social e a consolidação do Sistema Único de Saúde no Brasil.

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RESUMO A pandemia de covid-19 reduziu o acesso aos alimentos e aumentou a insegurança alimentar. Objetivouse analisar a prevalência de Insegurança Alimentar e Nutricional (IAN) em adolescentes brasileiros durante a pandemia de covid-19 segundo características sociodemográficas e examinar a associação entre IAN e comportamentos de risco e proteção em adolescentes brasileiros durante esse período. Estudo transversal com dados da ‘ConVid Adolescentes – Pesquisa de Comportamentos’, realizada entre junho e outubro de 2020, utilizando-se um questionário autoaplicado por meio de celular ou computador. A população foi adolescentes de 12 a 17 anos, totalizando 9.470. Utilizou-se a Razão de Prevalência (RP) e Intervalo de Confiança de 95% (IC95%), por meio da regressão de Poisson com variância robusta. A prevalência de IAN (26,1%) foi mais elevada entre os adolescentes da raça/cor preta e parda e que estudam em escola pública. Os adolescentes que relataram IAN tiveram menor consumo de hortaliças e frutas, menor prática de atividade física e maior uso de cigarros e álcool. A IAN foi mais prevalente em adolescentes com piores condições socioeconômicas, e, adolescentes com IAN apresentaram maior frequência de comportamentos de risco para a saúde evidenciando a importância de políticas públicas intersetoriais para a redução de desigualdades.

Resumo Introdução: As desigualdades sociais afetam historicamente as condições de vida e saúde das populações, e o padrão alimentar associa-se à situação socioeconômica dos indivíduos. Objetivo: Avaliar a magnitude das desigualdades sociais em indicadores de qualidade alimentar na população de Campinas-SP. Método: Estudo transversal, de base populacional, com 1.710 adultos e idosos entrevistados em 2014/15. Foram estimadas as prevalências e as razões de prevalência do consumo de alimentos avaliado por um questionário de frequência alimentar; além disso, foram verificadas as disparidades sociais segundo sexo, idade, escolaridade, renda e posse de plano de saúde. Resultados: Maior frequência de consumo de alimentos saudáveis foi verificada nas mulheres, nos idosos, nos estratos de maior nível de escolaridade e renda e no segmento social com plano de saúde. Por outro lado, paradoxalmente, os grupos sociais mais favorecidos não apresentaram menor consumo de refrigerantes, sucos artificiais, embutidos e biscoitos e bolachas nem apresentaram consumo maior de alimentos não saudáveis. Os idosos apresentam qualidade alimentar superior a todos os segmentos estudados. O segmento sem plano de saúde (usuários do SUS) teve pior perfil de consumo de alimentos, exceto para feijão e fast food. Conclusão: Expressivas desigualdades sociodemográficas foram detectadas, e os perfis combinaram o consumo de alimentos saudáveis e não saudáveis.

As the average life expectancy continues to rise, the prevalence of multimorbidity is also expected to increase, potentially leading to outcomes such as functional decline, a higher risk of premature death, and adverse effects on overall health and well-being. This study aimed to estimate the survival rates of older adults with varying levels of health-related quality of life (HRQoL) and to assess the association between the domains and components of the 36-item Short Form Health Survey and all-cause mortality over a 10-year period in Brazil. We conducted a retrospective longitudinal study using baseline data from 1,520 elders (aged 60 years and older) who participated in the Health Care Survey of the Municipality of Campinas, São Paulo, Brazil (ISACamp 2008/2009). A linkage was established between the ISACamp databases and the Mortality Information System. An active search was performed for individuals whose data could not be paired to confirm the death status. Survival functions were calculated using the Kaplan–Meier method, while hazard ratios (with 95% confidence intervals) were determined using Cox regression analysis. All HRQoL domains showed proportional hazards and statistically significant differences (p < 0.05) between survival curves, except for the bodily pain domain. In the multivariate analysis, lower scores in physical functioning and role-physical were associated with a 74% and 42% increased risk of death, respectively. In addition, impairments in role-emotional, mental health, and general health heightened the risk of mortality by approximately 36%. Notably, the lowest score in the physical component emerged as a significant predictor of mortality, increasing the probability of death by 47%, while the mental component showed no significant association. Our findings provide compelling evidence of the predictive capacity of HRQoL in evaluating mortality risk among older people in low- and middle-income countries.

The study of the association of social variables with the prevalence of impairments can provide subsidies for more adequate care and health policies for the most needy people by incorporating social aspects. This article aims to estimate the prevalence of diverse types of impairments, the degree of difficulty, limitations, and the need for help they cause and attest whether this prevalence differ by educational attainment in individuals aged 20 years or older. This is a populational cross-sectional study (2015 Health Survey of São Paulo-ISA Capital). Data from 3184 individuals were analyzed via educational attainment as exposure variable and outcome variables related to visual, hearing, intellectual, and mobility impairments. 19.9% of participants had visual, 7.8%, hearing, 2.7%, intellectual, and 7.4%, mobility impairments. Mobility and intellectual impairments limited participants' daily activities the most, 70.3% and 63.3%, respectively; who, thus, needed the most help: 48.9% and 48.5%, respectively. Lower schooling was associated with a higher prevalence of impairments, greater need for help due to visual and intellectual impairments, and greater limitations due to hearing and visual impairments.

This cross-sectional study aimed to identify factors related to the fragmentation and stability of the rest-activity rhythm (RAR) in adults and older adults. It is part of a larger research project investigating aspects concerning sleep duration, quality, and disorders in a representative subsample of the population. Sociodemographic data, lifestyle, health habits and subjective sleep variables were obtained; RAR records were collected by means of actigraphy and analyzed using non-parametric variables (IS, IV, M10, L5, RA, sL5, and sM10). Study participants were 313 individuals with complete actigraphy records. There was a prevalence of older adults (50.2%) and females (51.1%). Females, individuals with 4-8 y of education, and those who used alcohol abusively exhibited lower RAR fragmentation. Higher fragmentation was observed in individuals who napped and those reporting poor sleep quality. Greater rhythm stability was evident in females, older adults, those with 4-8 y of education, and those who had a partner. Smokers demonstrated lower RAR stability. These findings may contribute valuable insights for decision-making aimed at preventing and treating issues related to fragmentation and instability of the rhythm and its possible consequences to health.

Resumo Introdução O cálcio é um mineral essencial para inúmeras funções do organismo, não obstante, fatores associados à sua ingestão por adultos e idosos ainda não foram suficientemente estudados. Objetivo Estimar a ingestão média de cálcio tanto em adultos quanto em idosos, identificando os fatores associados a sua ingestão e as principais fontes alimentares deste mineral. Método Foram analisados os dados de uma amostra composta por 1.643 indivíduos, utilizando o inquérito do Inquérito Domiciliar de Consumo Alimentar e Estado Nutricional (ISACamp-Nutri) realizado em 2015 em Campinas, SP. A ingestão de cálcio foi avaliada por meio do Recordatório Alimentar de 24 horas (R24h). As diferenças entre as médias foram estimadas por meio de regressão linear de acordo com as variáveis sociodemográficas, o estado de saúde, o estilo de vida e a frequência de refeições dos participantes. Resultados A média de ingestão de cálcio foi de 542,5 mg/dia. O modelo final indicou que as médias foram inferiores nos homens, nos negros, naqueles com menores níveis de renda e de escolaridade, nos indivíduos com sobrepeso/obesidade e naqueles que faziam café da manhã e lanches com menos frequência. Ademais, demonstrou-se que os produtos lácteos contribuíram com apenas 40,6% da ingestão deste mineral. Conclusão Os resultados da presente pesquisa apontam que a ingestão de cálcio se encontra muito abaixo do recomendado, sendo ainda menor nos grupos populacionais supramencionados, enfatizando a necessidade de implementar políticas voltadas para a redução dos preços de alimentos ricos em cálcio, em conjunto com orientações para aumentar o seu consumo.

This study aimed to analyze the prevalence of indicators of use of healthcare services according to sex, income and race/skin color, in adolescents (aged 10-19 years old) based on data from the Health Survey of the Municipality of Campinas (ISACamp), carried out in 2014/2015 in Campinas, São Paulo, Brazil. The chi-square test was used to evaluate the differences between the outcome variables (indicators of use of healthcare service) and sex, income and race/skin color. Adjusted prevalence ratios (PR) were estimated using Poisson multiple regression models. The demand for medical care was high in the last year of the interview (79.2%), mostly attended by the Brazilian Unified National Health System (65.2%), with routine consultations being more prevalent for females (PR = 1.17; 95%CI: 1.01-1.34) and injury for the male population (PR = 0.47; 95%CI: 0.26-0.84). Economic and racial differences were found in the evaluation of the last medical consultation, with a higher prevalence of worse care among those with lower income (PR = 1.46; 95%CI: 1.14-1.87) and black people (PR = 1.27; 95%CI: 1.01-1.61). Inequalities remained for delay or failure to carry out exams (PR = 1.64; 95%CI: 1.02-2.64) and worse quality of dental care (PR = 2.10; 95%CI: 1.38-3.21) in those with lower income. Also, black people had fewer appointments with dentists (PR = 0.90; 95%CI: 0.82-0.99).

Resumo O objetivo do artigo é verificar se existem diferenças entre os sexos quanto aos fatores que se associam à ingestão de cálcio. Estudo realizado com dados de inquérito de saúde, em amostra de 1.640 indivíduos de 20 anos ou mais residentes no município de Campinas-SP. A ingestão de cálcio foi obtida por meio de um recordatório de 24 horas (R24h) e analisada segundo variáveis sociodemográficas, de comportamentos de saúde, frequência de refeições e índice de massa corporal (IMC); a presença de associações foi verificada por meio de testes de regressão linear múltipla. O perfil de fatores associados à ingestão de cálcio diferiu entre os sexos. A prática de atividade física no contexto de lazer só se associou ao consumo de cálcio no sexo masculino, enquanto cor da pele, tabagismo, renda, excesso de peso e frequência do café da manhã mostraram associação apenas no sexo feminino. Escolaridade e realização de lanches intermediários mostraram-se associadas à ingestão de cálcio em ambos os sexos. A análise aponta segmentos da população feminina e masculina em que a importância da ingestão de cálcio precisa ser mais enfatizada; além disso, alerta para a importância do desenvolvimento de análises de saúde estratificadas por sexo em decorrência de diferentes padrões comportamentais que prevalecem entre os sexos.

This article aims to estimate the prevalence of musculoskeletal disorders (MD) on the adult population of Campinas, São Paulo, Brazil, verifying associated demographic and socioeconomic factors, and to analyze their impact on Health-Related Quality of Life (HRQoL) according to sex. A population-based study was conducted with 2,166 individuals using data from the ISACamp 2014/15. The Medical Outcomes Study SF-36-Item Short Form Health Survey (SF-36) was used to measure HRQoL according to MD. Prevalence ratios (PR) were estimated by Poisson regression. Musculoskeletal disorders had a prevalence of 8.5% (6.7% tendonitis and 2.7% work-related musculoskeletal disorders - WMSD). Results showed a higher prevalence of musculoskeletal disorders in women, active or on leave due to illness, and in individuals with higher education levels. Moreover, reduced HRQoL scores were observed in 6 of the 8 domains, due to MD. The mental component and physical component showed greater impairment respectively among women and men after self-reported WMSD. These findings point to substantial damage from musculoskeletal disorders on the population's HRQoL. WMSD affect the HRQoL of men and women distinctly.

Background: modifiable risk factors related to lifestyle have possible low-cost interventions and, although potentially relevant in defining the epidemiological profile of the population and being associated with decreased early mortality from cardiovascular disease, these are not being monitored so that they can be assessed globally. So, the purpose of the study was to describe, analyze, and compare the lifestyle in the city of São Paulo in 2003 and 2015. Methods: this is a cross-sectional, population-based study that utilized data from the Health Survey of the City of São Paulofrom 2003 and 2015, selecting individuals of both sexes, aged 12 years and older. The study evaluated smoking, leisure-time physical activity, dependency, abusive alcohol consumption, frequent alcohol consumption, intake of fruits, vegetables, and greens, and overweight. Prevalence estimates and 95% confidence intervals were calculated for each lifestyle-related variable in 2003 and 2015, according to age group, sex, and education level. Poisson regression models were used to estimate adjusted prevalence ratios by age group, sex, and education level. Results: between 2003 and 2015, smoking decreased by 15% overall, 39% among adolescents, and 15% among adults. Insufficient intake of fruits, vegetables, and greens decreased by 7% overall, 11% among adults, 8% in males, 7% in females, 7% in those with intermediate education, and 17% in those with higher education. Frequent alcohol consumption decreased by 25.8% among those with higher education. Overweight increased by 37% overall, with significant increases in all age, gender, and educational categories. Conclusions: smoking, frequent alcohol consumption, and insufficient intake of fruits, vegetables, and greens showed positive decreases. Conversely, overweight exhibited negative increases across all analyzed categories. Given the existence of current public policies related to the presented risk factors, there is a need for evaluation and improvement of existing policies, especially those intervening in factors with the worst outcomes.

ABSTRACT The COVID-19 pandemic has reduced access to food and increased food insecurity. The objectives were to analyse the prevalence of Food and Nutritional Insecurity (FNI) in Brazilian adolescents during the COVID-19 pandemic according to sociodemographic characteristics and to examine the association between FNI and risk and protective behaviours in Brazilian adolescents during the that period. Cross-sectional study with data from the ‘ConVid teenagers – Behaviour Survey,’ carried out between June and October 2020, using a self-administered questionnaire via mobile phone or computer. The population was made up of teenagers aged 12 to 17, totalling 9,470. The Prevalence Ratio (PR) and 95% Confidence Interval (95% CI) were used, using Poisson regression with robust variance. The prevalence of FNI (26.1%) was higher among adolescents of black and mixed race/colour and who study in public schools. Adolescents who reported FNI had lower consumption of vegetables and fruits, less physical activity, and greater use of cigarettes and alcohol. FNI was more prevalent in adolescents with worse socioeconomic conditions, and adolescents with FNI showed a higher frequency of health risk behaviours, highlighting the importance of intersectoral public policies to reduce inequalities.