O estresse crônico está associado a diversas morbidades, mas seus efeitos fisiológicos ainda demandam maior compreensão, especialmente em relação a biomarcadores inflamatórios. Este estudo investigou a associação entre eventos estressores e níveis médios de proteína-C reativa (PCR) e interleucina-6 (IL-6), transversalmente (aos 18 e 22 anos) e longitudinalmente (exposição aos 18 e desfecho aos 22 anos). Foram incluídos participantes da coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, de 1993, com dados completos nas duas idades (n = 2.871 aos 18 anos; n = 2.444 aos 22 anos). A exposição foi avaliada como número de eventos estressores (nenhum, 1, ≥ 2) e em grupos de eventos estressores (6 grupos aos 18 anos; 8 grupos aos 22 anos). Modelos de regressão linear avaliaram as associações, incluindo análise de interação por sexo. As associações não estratificadas foram nulas ou controversas. Após estratificação por sexo, observaram-se associações transversais: aos 22 anos, homens expostos a abuso físico apresentaram níveis mais elevados de PCR (β logPCR: 0,41, IC95%: 0,04; 0,78) e IL-6 (β logIL-6: 0,26, IC95%: 0,06; 0,46) do que os não expostos; aos 18 anos, mulheres expostas a mudanças indesejadas tiveram maiores níveis de IL-6 (β: 0,15, IC95%: 0,02; 0,28), enquanto aos 22 anos, aquelas com problemas nas relações apresentaram níveis mais baixos de PCR (β: -0,15, IC95%: -0,29; -0,01) em comparação às não expostas. Os resultados sugerem que o impacto dos eventos estressores na inflamação varia conforme o tipo de eventos estressores, idade e sexo, possivelmente refletindo diferenças em mecanismos biopsicológicos.

We examined adiposity trajectories (body mass index - BMI and body fat percentage - BF%) from ages 11 to 22 years and described them according to sex and maternal characteristics. Data were analyzed from the 1993 Pelotas (Brazil) birth cohort. BMI (n = 3,072) and BF% (n = 3,058) measurements were assessed at four time points (11, 15, 18, and 22 years). Trajectories were found using a group-based modeling approach by sex and described according to maternal characteristics using the Pearson’s chi-squared test. This study found three BMI trajectories: “always adequate”, “always with overweight”, and “always with obesity”. Approximately 40% of the cohort was classified as “always with overweight” or “always with obesity”. For BF%, three trajectories were observed among males, including one with a consistently low BF% over time, whereas women’s trajectories showed an increase in BF% from adolescence onward. Maternal overweight was associated with higher adiposity trajectories in both sexes. Men with higher family income and lower maternal education had a higher prevalence of high adiposity trajectories for both BMI and BF%. In women, those from lower-income backgrounds had a higher prevalence of the “always with overweight” or “always with obesity” trajectories. The adiposity trajectories of men and women belonging to the 1993 birth cohort suggest significant increases in body fat from ages 11 to 22 years, and even more pronounced upward trajectories when these youths’ mothers were overweight at the beginning of this trajectory.

Este estudo buscou identificar a prevalência de síndrome metabólica aos 22 e 30 anos abordando desigualdades por sexo, cor da pele e posição socioeconômica, e suas intersecções. Análise transversal utilizando dados das coortes de nascimento de Pelotas, Rio Grande do Sul, Brasil, de 1993 (22 anos) e de 1982 (22 e 30 anos). A síndrome metabólica foi definida pelos critérios da National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) e da Federação Internacional de Diabetes (IDF). As desigualdades entre sexo, cor da pele e posição socioeconômica foram descritas em Equiplots e analisadas por medidas absolutas (diferença de prevalência e índice de inclinação da desigualdade – SII]) e relativas (razão de prevalência e índice de concentração – CIX]). Aos 22 anos, a prevalência de síndrome metabólica foi de 18,2% (IDF) e 13,5% (NCEP-ATP III) (coorte de 1993), e de 11,3% (IDF) e 8,6% (NCEP-ATP III) (coorte de 1982). Aos 30 anos (coorte de 1982), foi de 15,5% (IDF) e 10,7% (NCEP-ATP III). A maior desigualdade por posição socioeconômica ocorreu na coorte de 1982 aos 22 anos, pelo NCEP-ATP III: entre mulheres (SII: -8,7p.p.; [IC95%: -13,2; -4,2]; CIX: -20,1%; [IC95%: -29,7; -10,5]) e homens (SII: 6,5p.p.; [IC95%: 0,1; 12,9]; CIX: 7,9%; [IC95%: 0,6; 15,3]). Os subgrupos mais acometidos foram: mulheres brancas de posição socioeconômica inferior, homens pretos/pardos (coorte de 1993) e homens brancos (coorte de 1982) de posição socioeconômica superior. Nossos resultados reforçam que a síndrome metabólica não está distribuída de forma homogênea nesta população e que sua ocorrência pode ser influenciada por intersecções entre posição socioeconômica, sexo e cor da pele.

Suicidal and self-injurious behaviors are major public health issues, disproportionately affecting youth. While global suicide rates declined, Brazil has seen a significant rise over recent decades. Considering the persistent social inequality in Brazil, especially among Black/Mixed-race women, an intersectional approach is essential to understanding how the combination of social identities impacts health. This study analyzes reported intentional self-inflicted injury rates among Brazilian people (18-30 years) from 2014 to 2023, according to race/skin color, sex, and their intersection. Data were obtained from official public records (Brazilian Information System for Notifiable Diseases). Intentional self-inflicted injury rates were estimated nationally and by macroregion, for the population aged 18 to 30 years, according to race/skin color, sex, and their intersection. Brazilian national intentional self-inflicted injury rates increased 638% (24.2 to 178.5/100,000), with regional increases up to 969%. Females had higher rates than males, and Mixed-race individuals showed the steepest rise (890%). Intersectional analysis revealed that White females had the highest rates, but Mixed-race females experienced the most significant increase (914%). Regional variations were notable, Mixed-race females led in the North, Northeast and Central-West, while White females dominated the South and Southeast. Intentional self-inflicted injury rates surged among Brazilian people (18-30 years), particularly White/Mixed-race women and Mixed-race individuals, with substantial regional variation. Intersectional and contextual factors (healthcare access, gender, and socioeconomic) are likely contributors. These findings suggest combined effects of racial and gender inequities, policy responses must address intersectional vulnerabilities.

Abstract Objective: To analyze sleep duration and quality at different ages according to sociodemographic factors. Methods: This was a cross-sectional study using data from the 1993 Pelotas Birth Cohort in Rio Grande do Sul, Brazil, with follow-ups conducted at ages 11, 18, and 22. Sleep duration and quality were self-reported; daily sleep duration was estimated from weekday bedtime and wake-up times, and sleep quality was assessed at 22 years of age using a question about sleep perception. Descriptive analyses were performed, and inequality measures were estimated according to sex, race/skin color, and wealth index. Results: A total of 4,439, 4,081, and 3,800 individuals were analyzed at ages 11, 18, and 22, respectively. Mean sleep duration was 9.7 (95% confidence interval [95%CI] 9.6; 9.7), 8.4 (95%CI 8.3; 8.5), and 8.0 (95%CI 7.9; 8.0) hours. The absolute inequality index at 18 years of age was -1.3 (95%CI -1.5; -1.0) among females and -0.7 (95%CI -1.0; -0.4) among males. At 22 years of age, the proportion reporting “very good” sleep quality was 19.2% (95%CI 17.4; 21.1) among males, while “very poor” sleep quality was 5.2% (95%CI 4.3; 6.2) among females. Conclusion: Sleep duration decreased between 11 and 22 years of age and was longer among females and more vulnerable groups, among whom very good sleep quality was less frequent.

Chronic stress is associated with various morbidities, but the physiological effects require greater understanding, especially with regards to inflammatory biomarkers. This study investigated the association between stressful events and mean levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in both cross-sectional (at ages 18 and 22) and longitudinal (exposure at age 18 and outcome at age 22) analyses. Participants from the 1993 Pelotas (Brazil) birth cohort with complete data at both ages were included (n = 2,871 at age 18; n = 2,444 at age 22). Exposure was assessed as the number of stressful events (none, 1, ≥ 2) and by stressful events group (6 groups at age 18; 8 groups at age 22). Linear regression models were used for the determination of associations, including the analysis of interactions with sex. Unstratified associations were either null or conflicting. Cross-sectional associations were observed after stratification by sex: at 22 years of age, men exposed to physical abuse had higher levels of CRP (β logCRP: 0.41, 95%CI: 0.04; 0.78) and IL-6 (β logIL-6: 0.26, 95%CI: 0.06; 0.46) than those not exposed; at 18 years of age, women exposed to unwanted changes had higher IL-6 levels (β: 0.15, 95%CI: 0.02; 0.28), while at 22 years of age, those with relationship problems had lower CRP levels (β: -0.15, 95%CI: -0.29; -0.01) compared to those not exposed. The results suggest that the impact of stressful events on inflammation varies according to the type of event, age, and sex, possibly reflecting differences in biopsychological mechanisms.

The aim of the present study was to identify the prevalence of metabolic syndrome at 22 and 30 years of age, determine inequalities by sex, skin color, and socioeconomic status, and investigate the intersections of these variables. A cross-sectional analysis was conducted using data from the 1993 (22 years of age) and 1982 (22 and 30 years of age) Pelotas (Brazil) birth cohort. Metabolic syndrome was defined based on the criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and the International Diabetes Federation (IDF). Inequalities in terms of sex, skin color, and socioeconomic status were described in Equiplots and analyzed by absolute measures (prevalence ratio and slope index of inequality - SII]) and relative measures (difference in prevalence and concentration index - CIX]). At 22 years of age, the prevalence of metabolic syndrome was 18.2% (IDF) and 13.5% (NCEP-ATP III) in the 1993 cohort, and 11.3% (IDF) and 8.6% (NCEP-ATP III) in the 1982 cohort. At 30 years of age (1982 cohort), the prevalence was 15.5% (IDF) and 10.7% (NCEP-ATP III). The greatest inequality in terms of socioeconomic status occurred in the 1982 cohort at 22 years of age based on the NCEP-ATP III criteria among women (SII: -8.7p.p. [95%CI: -13.2; -4.2]; CIX: -20.1% [95%CI: -29.7; -10.5]) and men (SII: 6.5p.p. [95%CI: 0.1; 12.9]; CIX: 7.9% [95%CI: 0.6; 15.3]). The most affected subgroups were White women with a lower socioeconomic status and Black/Mixed-race men (1993 cohort) and White men (1982 cohort) with a higher socioesconomic status. Our results demonstrate that metabolic syndrome is not evenly distributed in this population and that its occurrence may be influenced by intersections between socioeconomic status, sex, and skin color.

Given the evidence linking ultra-processed food consumption to adverse health outcomes and the lack of longitudinal studies jointly addressing ultra-processed food consumption and body mass index (BMI), this study identified multi-trajectory groups from adolescence to early adulthood and described their demographic and behavioral characteristics. Data from the 1993 Pelotas (Brazil) birth cohort at ages 15, 18, and 22 (n = 2,890) were analyzed. Sex-stratified multi-trajectory groups of daily ultra-processed food consumption and BMI (z-scores for age and sex) were estimated using Group-Based Trajectory Modelling. Daily ultra-processed food consumption was defined as the number of ultra-processed food items consumed at least once per day. Sixteen NOVA-classified foods were grouped into six categories. Groups were described according to ultra-processed food types, poverty level, physical activity, screen time, smoking, alcohol use, and risk behaviors. Three multi-trajectory groups were identified: two with low ultra-processed food (group 1 and group 2) and one with increasing ultra-processed food intake (group 3). In group 1 (38.7% males; 34% females), BMI increased over time, while in group 2 (39.4% males; 44.5% females) it remained stable. In group 3 (21.9% males; 21.5% females), ultra-processed food consumption increased over time, particularly fast food, soft drinks, and processed meats, while BMI z-scores remained close to zero in males and increased in females. Risk behaviors increased over time in group 3, whereas poverty was less prevalent in group 1. Individuals in group 3 generally exhibited higher ultra-processed food intake and a greater prevalence of risk behaviors across follow-ups, despite BMI remaining within the normal range. Monitoring ultra-processed food consumption may help identify at-risk groups before excess weight becomes evident during adolescence and early adulthood.

Interpersonal violence is a major public health concern in Brazil, yet its epidemiology remains poorly understood. In this study, we examined four decades of violence using the municipality of Pelotas, Brazil, which has uniquely rich administrative and cohort data. We analysed trends in officially recorded and self-reported violence from 1980 to 2024 using administrative data and three population-based birth cohorts (1982, 1993, and 2004). Self-reported violence perpetration was measured using harmonised questionnaires at comparable ages and recall periods. LOESS regression smoothed long-term trends and chi-squared tests assessed changes in perpetrator profiles. Violence increased sharply from the 1980s, peaked in 2017, and declined thereafter, with consistent patterns observed across mortality, hospitalisation, and police records. Cohort data mirrored these trends: 12.6%-15.7% of individuals reported perpetrating violence, with the highest prevalence in the 1993 cohort. Individuals born in 2004 had 21% lower odds of perpetration compared with those born in 1993 (Odds ratio = 0.79; 95% confidence interval [0.69, 0.90]). Physical assault drove these trends, while weapon carriage increased in more recent cohorts. Socio-demographic patterns were largely stable over time; however, female perpetration increased across cohorts, particularly for physical assault and weapon carriage. These findings indicate that the rise in violence, and the more recent decline, in Brazil was universal and affected both lethal and non-lethal forms of violence. Additional research is needed to better understand the recent decline in violence and explore why violence perpetration might be becoming more prevalent among women. Understanding the evolving epidemiology of violence in Brazil is critical for designing responsive violence prevention strategies.

AIMS:Epidemiological evidence shows a concerning rise in youth mental health difficulties over the past three decades. Most evidence, however, comes from countries in Europe or North America, with far less known about changes in other global regions. This study aimed to compare adolescent mental health across two population-based cohorts in the UK, and two population-based cohorts in Pelotas, Brazil. METHODS:Four population-based cohorts with identical mental health measures were compared. In Brazil, these included the 1993 Pelotas Birth Cohort and the 2004 Pelotas Birth Cohort. In the UK, cohorts included the Avon Longitudinal Study of Parents and Children, and the Millennium Cohort Study. Mental health was measured in all cohorts using identical, parent-rated scores from the Strengths and Difficulties Questionnaire (SDQ). This was assessed in both countries over approximately the same time periods, when adolescents were aged 11 (2004 vs 2015 in Brazil, and 2003 vs 2012 in the UK), with follow-up analyses focused on outcomes in later adolescence. RESULTS:Mental health problems were higher in the UK for adolescents born in the early 2000s compared to those born in the early 1990s. In Pelotas, the opposite was found, whereby problems were lower for adolescents born in the early 2000s compared to those born in the early 1990s. Despite these promising reductions in mental health problems in Pelotas over time, SDQ scores remained higher in Pelotas compared to the UK. CONCLUSIONS:Our study represents the first to compare two population-based cohorts in the UK, and two population-based cohorts in Pelotas, Brazil, to understand how mental health problems have changed over time across the two settings. Our findings provide the most up-to-date insight into population-level rates of youth mental health problems in Pelotas, and shed novel insight into how these have changed over the last two decades in comparison to the UK. In doing so, our study provides a tentative first step towards understanding youth mental health over time at a more global scale, and presents a valuable opportunity to examine putative contributors to differences across time.

Childhood conduct problems are associated with problematic substance use in adulthood; however, little is known about what might explain these associations outside of high-income countries where the majority of research is conducted. Data were analyzed from 4599 young people from the 1993 Pelotas Birth Cohort in Brazil. The exposure was conduct problems (age 11 years). Outcomes included hazardous alcohol consumption and illicit drug use (age 22 years). Mediators included police arrest (by age 18 years), gang membership (ages 18 and 22 years), and school noncompletion (by age 22 years). We performed counterfactual mediation using the parametric g-computation formula to estimate the indirect effect via all three mediators simultaneously. After adjusting for confounders (including hyperactivity problems), conduct problems were weakly associated with police arrest (OR [95% CI] = 1.45 [0.97, 2.16]) and school noncompletion (OR [95% CI] = 1.46 [1.22, 1.74]), but not with gang membership. Police arrest and gang membership were associated with illicit drug use (OR [95% CI] = 3.84 [2.46, 5.99]; OR [95% CI] = 7.78 [4.30, 14.10], respectively) and with hazardous alcohol use (OR [95% CI] = 1.60 [1.08, 2.38]; OR [95% CI] = 1.88 [1.07, 3.30]), after adjusting for confounders (including hyperactivity and emotional problems). There was no association between school noncompletion and either outcome after confounder adjustment. There was little evidence for an indirect effect of conduct problems on hazardous alcohol use and illicit drug use via all three mediators after confounder adjustment. Findings highlight the importance of school professionals being aware of the risk for school noncompletion for those with conduct problems. Additionally, programmes designed to reduce substance use in Brazil should focus on young people involved in gangs, and in the criminal justice system.

Maternal anxiety can have a significant impact on a child's behavior. This study aimed to investigate the association between maternal anxiety and externalizing and internalizing behavioral problems in their offspring. Data were utilized from 530 mothers and their 740 children participating in the 1993 Pelotas Birth Cohort and the 1993 Cohort-II study, respectively. Maternal anxiety was assessed at ages 18 and 22 using the Mini International Neuropsychiatric Interview (MINI). At age 22, mothers completed the Child Behavior Checklist (CBCL) to assess externalizing and internalizing behavior problems in their children (aged 16 months to 10 years). Two samples were analyzed: one included all children, and the other was a subsample that included only one child per mother. In one-child-per-mother sample, children of mothers with anxiety had 4.63 (95 % CI: 2.28; 6.97), 3.35 (95 % CI: 0.92; 5.77), and 4.97 (95 % CI: 2.51; 7.43) points higher scores on internalizing, externalizing, and total problem scales, respectively, compared to children of mothers without anxiety. When including all children, the differences were 2.68 (95 % CI: 0.93; 4.44), 2.63 (95 % CI: 0.73; 4.52), and 2.60 (95 % CI: 0.87; 4.34) points, respectively. Understanding the mechanisms underlying this association, emphasized by these findings, is crucial for promoting children's mental health and well-being, as well as developing effective interventions to support both mothers and children.

Resumo Estudo longitudinal com o objetivo de avaliar a associação entre comportamento sedentário, avaliado por tempo de tela e acelerômetro, aos 18 e 22 anos, e padrões alimentares aos 22 anos em participantes da Coorte de Nascimentos de 1993 de Pelotas/RS. As exposições foram: tempo de tela no lazer autorrelatado, tempo sedentário medido por acelerômetro e mudança dos 18 aos 22 anos dos tempos de tela e sedentário. Pela análise de componentes principais, identificaram-se três padrões alimentares aos 22 anos: lanches e doces, saudável e comum brasileiro. As associações foram analisadas por regressão de Poisson bruta e ajustada (n = 3.396). Nas análises ajustadas foram encontradas associações entre maior tempo de tela aos 18 (RP: 1,23; IC95%: 1,08-1,40) e aos 22 anos (RP: 1,23; IC95%: 1,09-1,39) e maior adesão ao padrão lanches e doces. Tempo de tela sempre elevado aos 18 e 22 anos foi associado a maior adesão a lanches e doces (RP:1,31; IC95%: 1,03-1,67) e menor adesão ao padrão saudável (RP: 0,65; IC95%: 0,48-0,87), em comparação ao tempo de tela sempre baixo. Não foram encontradas associações com o tempo sedentário avaliado por acelerômetro. Concluiu-se que maior tempo de tela aos 18 e 22 anos está associado à adesão a um padrão alimentar considerado não saudável em adultos jovens.

This study describes key methodological decisions and their justifications for accelerometer data collection, processing, and cleaning/analysis in Pelotas (Rio Grande do Sul State, Brazil) cohorts, exemplifying how research using sensor monitors could be carried out in a middle-income country context. This is a descriptive methodological study using raw accelerometer data from five Brazilian population-based cohorts with 32,963 individuals. Data collection (pre-processing decisions), processing (choosing requirements to run the analysis), and post-processing decisions (data cleaning) are described in detail. Pre-processing includes choosing the device brand/model, placement of the device, algorithms/thresholds, and the number of days participants were required to wear the devices. Processing activities involve applying thresholds/algorithms to the data. Finally, post-processing includes data cleaning. The minimum number of days to be validated to correctly estimate weekly averages was specific to age and measurement. By summarizing and describing the methodological decisions and analysis protocol, we hope to contribute to the design and analysis of accelerometer data in future studies in similar research contexts.

PURPOSE:Violence prevention requires robust data on trends in different forms of violence and measures of progress toward reduction across subgroups of the population. This study aimed to investigate trends and related socioeconomic inequalities in parental physical aggression and involvement in physical fights among adolescents. METHODS:Three population-based birth cohorts were conducted, including all births in the calendar years 1982, 1993, and 2004 in Pelotas city, Southern Brazil, with over 4,200 births in each cohort. Confidential self-report questionnaires were used to measure parental physical aggression (ages 11 and 15 years) and involvement in physical fights (ages 11, 15, and 18). The prevalence of violence outcomes was estimated, stratifying by sex and family income group for each cohort, and income-related inequalities were assessed through time. RESULTS:There were significant reductions in parental physical aggression between cohorts, at ages 11 (prevalence ratio (PR): 0.83) and 15 years (PR: 0.70), and there was some evidence of reductions in income-related inequality regarding harsh parenting, mainly for boys. Considering physical fighting, there was a small increase through time for boys at age 11 (PR: 1.22), but no change for either sex at age 15, and declines for girls at age 18 years (PR: 0.50). There were income inequalities in physical fighting for girls at ages 11 and 15 (with a higher prevalence among the poorest adolescent girls in comparison to the richest), which persisted through time. However, income inequality in fighting among girls at age 18 reduced through time. There was little income inequality in fighting among boys at any age in any cohort. DISCUSSION:Encouraging declines in parental physical aggression have occurred over the past 2 decades in this population of adolescents, but there is less clear evidence of changes in physical fights. Continued monitoring is vital to inform violence prevention policies.

INTRODUCTION:This study aimed to describe the prevalence of untreated dental caries in early childhood based on intergenerational socioeconomic data and to evaluate the association between intragenerational socioeconomic mobility data and untreated dental caries in children aged 4. METHODS:This is a longitudinal study. Data from three birth cohorts in Pelotas (1982, 1993, and 2015) were used. Data from three generations participating in these cohorts were evaluated. Untreated dental caries in childhood (2015 cohort) was considered the dependent variable. Family income and schooling were independent variables. The social mobility variable was categorized considering income and level of schooling data in the mothers' generation. Poisson regression was performed to estimate prevalence ratios (PRs) and 95% confidence intervals (95% CIs). RESULTS:A total of 286 pairs of children and mothers/grandmothers were evaluated for the intergenerational sample (1982 and 1993 cohorts), and 3,633 mothers and children for the intragenerational sample (2015 cohort). In the intergenerational analysis, there was a reduction of about 10 percentage points in the prevalence of untreated caries in children from families that experienced upward/downward income mobility compared to children whose generations remained with lower income. In the intragenerational analysis, children belonging to the ascending/descending economic mobility groups had twice the prevalence of untreated dental caries compared to those always with higher salaries (PR 2.04; 95% CI 1.52-2.71 and PR 2.07; 95% CI 1.56-2.74, respectively). CONCLUSION:Findings demonstrate an association between untreated dental caries in children and family socioeconomic status, including their mothers' income/education mobility. Thus, intervening in early childhood socioeconomic conditions is needed to improve children's oral health.

Stressful events are avoidable and potentially traumatic situations that cause damage to physical and mental health. Research on this topic is generally carried out in contexts without significant social inequalities. We described the prevalence and inequality measures for exposure to different stressful events according to sex, skin color, family income, and schooling using data from five follow-ups of the 1993 Pelotas (Brazil) birth cohort. We evaluated stressful events until adolescence (< 18 years, n = 2,755), in adulthood (18-30 years, n = 1,752), and in both periods (n = 1,400). The characteristics of the analytical samples were approximated to baseline using inverse probability weighting. Simple and complex measures were used to measure inequalities (difference, ratio, SII, and CIX). Until adolescence, the most prevalent stressful events were parental separation (67.5% of men) and the death of a relative (66.1% of women). The death of a relative was the most prevalent stressful event for both sexes in adulthood (men: 65.8%; women: 63.2%) and in both periods (men: 44.1%; women: 44.2%). Regardless of the period of life, black, less educated, and poorer individuals were the most exposed to the majority of stressful events. Emotional neglect, incarceration, parental separation, and discrimination were among the most unequal exposures, with blacks, those with less schooling, and the poorest being most affected, women being more exposed to emotional neglect and discrimination, and men to the other exposures. Physical and mental health care programs should be developed to prevent such exposures and minimize their damage to health, especially in the most vulnerable groups.

Early diagnosis can be a beneficial factor for minimizing health risks related to multimorbidity. This study aims to assess the association of multimorbidity with interleukin 6 (IL-6), C-reactive protein (CRP), and adiponectin in 22-year-old participants of the Pelotas (Brazil) birth cohort. A total of 3,578 subjects had serum measurements of IL-6, CRP, and adiponectin at the 22-year-old visit. For multimorbidity evaluation, a list of 15 morbidities was used and divided into subgroups (cardiometabolic, pulmonary, allergic diseases, and mental disorders). The occurrence of ≥ 2 morbidities was higher in females (55.1%) than in males (45.2%). A negative association between multimorbidity and adiponectin was found in females, whereas positive associations between the number of diseases and IL-6 and CRP were observed in males. For both sexes, cardiometabolic problem was the morbidity most associated with the markers. The analysis for isolated diseases identified dyslipidemia was the only cardiometabolic condition associated with physiological markers. Our findings suggest an inverse association between multimorbidity and adiponectin in females, as well as a direct cumulative association between the number of diseases and IL-6 and CRP in males at a young age.

This study aimed to investigate the association between child maltreatment and human capital, measured by intelligence quotient (IQ) at age 18 years and schooling at age 22 years in 3,736 members from a population-based birth cohort in Southern Brazil. A multiple linear regression was used to assess the association between child maltreatment and human capital measurements. Physical and emotional abuse and physical neglect occurring up to 15 years of age were considered child maltreatment. Physical neglect was associated with lower IQ scores in women (β = -4.40; 95%CI: -6.82; -1.99) and men (β = -2.58; 95%CI: -5.17; -0.01) and lower schooling for all sexes: women (β = -1.19; 95%CI: -1.64; -0.74) and men (β = -0.82; 95%CI: -1.34; -0.30). Moreover, men who had experienced one type of child maltreatment and women who had experienced two or more types had lower years of schooling at 22 years (β = -0.41; 95%CI: -0.73; -0.89 and β = -0.57; 95%CI: -0.91; -0.22, respectively) than those who suffered no kind of maltreatment. Efforts to improve future educational and cognitive outcomes must include early prevention and intervention strategies for child maltreatment.