Social distancing, use of face masks and hand washing among participants in the <i>Brazilian Longitudinal Study of Aging</i>: <i>the ELSI-COVID-19 initiative</i>

Lima-Costa, Maria Fernanda; Mambrini, Juliana Vaz de Melo; Andrade, Fabiola Bof de; Peixoto, Sérgio William Viana; Macinko, James

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ARTICLE • Cad. Saúde Pública 36 (Suppl 3) • 2020 • https://doi.org/10.1590/0102-311X00193920 copy

Social distancing, use of face masks and hand washing among participants in the Brazilian Longitudinal Study of Aging: the ELSI-COVID-19 initiative

Authorship SCIMAGO INSTITUTIONS RANKINGS

The aim of the study was to examine the prevalence of social distancing, the use of face masks and hand washing when leaving home among Brazilian adults aged 50 or over. Data from 6,149 telephone interviews were used, conducted between May 26 and June 8, 2020 among participants in the Brazilian Longitudinal Study of Aging (ELSI-Brazil). Social distancing was defined by not having left home in the last seven days. Only 32.8% of study participants did not leave home during the period considered, 36.3% left between one and two times, 15.2% between three and five times and 15.7% left every day. The main reasons for leaving home were to buy medicine or food (74.2%), to work (25.1%), to pay bills (24.5%), for health care (10.5%), to exercise (6.2%), and to meet family or friends (8.8%). Among those who left home, 97.3% always wore face masks and 97.3% always performed hand washing. Women left home less often than men. Men left home more often to work and exercise while women left home more often to seek healthcare. Men (odds ratio - OR = 1.84), those with higher education (OR = 1.48 and 1.95 for 5-8 and 9 years, respectively) and urban residents (OR = 1.54) left home more frequently to perform essential activities, regardless of age or other characteristics. Results show low adherence to social distancing, but high prevalence in the reported use of face masks and hand washing.

Keywords:
Coronavirus; COVID-19; Masks; Social Isolation; Aging

Behaviors	Total	Women	Men	p-value
	% (95%CI)	% (95%CI)	% (95%CI)
Frequency of leaving the house (< 7 days)
Did not leave	32.8 (30.03-5.7)	38.2 (34.3-42.2)	26.3 (22.3-30.8)	< 0.001
1-2 times	36.3 (33.3-39.4)	40.1 (35.1-45.3)	31.9 (28.3-35.6)
3-5 times	15.2 (12.6-18.3)	11.8 (9.5-14.5)	19.3 (14.8-24.9)
Nearly every day	15.7 (12.6-19.3)	10.0 (7.7-12.8)	22.5 (17.5-28.4)
Used a face mask when outside the house
Always	97.3 (96.2-98.1)	98.9 (98.1-99.4)	95.7 (93.9-97.0)	< 0.001
Sometimes	2.0 (1.3-3.1)	0.7 (0.3-1.7)	3.3 (2.2-5.2)
Never	0.7 (0.4-1.2)	0.4 (0.2-0.5)	0.9 (0.4-2.1)
Washed hands with soap and water or hand sanitizer
Always	97.3 (95.7-98.4)	98.6 (96.6-99.4)	96.1 (93.5-97.7)	0.038
Sometimes	2.0 (1.2-3.4)	0.8 (0.4-1.6)	3.2 (1.8-5.7)
Never	0.7 (0.2-1.9)	0.7 (0.1-3.7)	0.7 (0.2-1.9)
Reasons for leaving the house
To work	25.1 (20.4-30.6)	14.0 (10.6-18.2)	36.2 (29.5-43.6)	< 0.001
To buy food or medicine	74.2 (69.7-78.2)	75.0 (69.0-80.2)	73.4 (67.4-78.6)	0.656
To meet friends or family	8.8 (6.7-11.6)	10.2 (6.8-15.0)	7.5 (5.0-11.0)	0.277
To obtain health services	10.5 (8.5-12.9)	13.5 (10.5-17.3)	7.4 (5.5-9.9)	< 0.001
To walk or do exercises	6.2 (4.5-8.4)	3.5 (2.3-5.2)	8.9 (6.3-12.5)	< 0.001
To pay bills	24.5 (20.7-28.6)	22.5 (17.3-28.7)	26.4 (22.5-30.7)	0.217
Other reasons	10.7 (8.8-13.1)	10.4 (7.7-13.9)	11.1 (8.7-14.0)	0.703
Number of respondents (unweighted)	6,123	3,665	2,458

Variables	Reasons for leaving the house % (95%CI)			p-value
Variables	Did not leave	Left for essential activities	Left for non-essential activities
Gender
Female	38.2 (34.3-42.2)	56.0 (51.6-60.3)	5.8 (3.8-9.1)	0.001
Male	26.3 (22.3-30.8)	68.1 (63.2-72.2)	5.6 (4.0-7.6)
Age group (years)
50-59	22.6 (19.3-26.3)	71.8 (67.0-76.0)	5.6 (3.6-8.8)	< 0.001
60-69	30.0 (26.7-33.6)	64.2 (60.3-68.0)	5.8 (4.1-8.1)
70 and older	56.1 (50.9-61.1)	38.1 (33.6-42.9)	5.8 (4.0-8.4)
Marital status
Single/Divorced	31.1 (27.4-35.2)	62.2 (57.0-67.2)	6.7 (3.5-12.5)	< 0.001
Married	29.1 (25.8-32.7)	65.6 (61.5-69.5)	5.3 (4.0-7.0)
Widowed	49.7 (43.5-56.0)	44.5 (38.2-50.9)	5.8 (3.6-9.2)
Education (years)
Up to 4	46.4 (43.1-49.9)	46.6 (43.4-49.8)	7.0 (5.5-8.8)	< 0.001
5-8	31.4 (27.4-35.7)	64.3 (60.1-68.2)	4.3 (2.9-6.6)
9 years or more	25.1 (20.8-29.8)	69.1 (63.6-74.2)	5.8 (3.3-10.0)
Number of household residents
1	33.2 (26.4-40.8)	59.7 (51.2-67.7)	7.0 (3.4-14.0)	0.574
2	34.0 (30.4-37.7)	60.0 (55.8-64.0)	6.1 (4.4-8.4)
3 or more	31.2 (26.5-36.3)	64.3 (58.9-69.3)	4.5 (3.3-6.2)
Household has inhabitant < 20 years old
No	32.9 (29.7-36.2)	60.9 (57.1-64.6)	6.3 (4.5-8.6)	0.209
Yes	32.3 (25.6-39.9)	64.3 (56.9-71.0)	3.4 (2.4-4.8)
Region
North	35.7 (24.7-48.6)	61.3 (49.1-72.2)	3.0 (2.2-4.1)	0.092
Northeast	36.9 (32.8-41.2)	56.6 (53.4-59.8)	6.5 (4.1-10.1)
Southeast	29.8 (24.8-35.3)	62.9 (56.1-69.3)	7.3 (4.4-11.8)
South	29.8 (21.2-40.1)	67.6 (57.7-76.1)	2.6 (1.7-4.0)
Central	36.7 (32.2-41.4)	59.4 (54.5-64.1)	4.0 (2.5-6.2)
Household location
Urban	31.1 (28.3-34.1)	63.4 (59.8-66.8)	5.5 (3.9-7.6)	0.001
Rural	44.1 (37.9-50.5)	48.5 (43.8-53.3)	7.4 (4.2-12.8)
Flu-like symptoms
No	33.1 (30.2-36.2)	61.1 (57.6-64.5)	5.7 (4.2-7.8)	0.705
Yes	29.5 (20.0-41.2)	65.0 (52.3-76.0)	5.5 (2.7-10.7)
Number of respondents (unweighted)	2,532	3,242	349

Variables	Left for essential activities	Left for non-essential activities
	OR (IC95%)	OR (IC95%)
Gender
Female	1.00	1.00
Male	1.84 (1.37-2.46) *	1.47 (0.83-2.62)
Age group (years)
50-59	1.00	1.0
60-69	0.69 (0.53-0.89) *	0.77 (0.45-1.33)
70 and older	0.24 (0.17-0.34) *	0.41 (0.25-0.67) *
Marital status
Single/Divorced	1.00	1.00
Married	1.12 (0.87-1.45)	0.78 (0.37-1.63)
Widowed	0.94 (0.63-1.39)	0.79 (0.46-1.37)
Education (years)
Up to 4	1.00	1.00
5-8	1.48 (1.12-1.94) *	0.79 (0.48-1.29)
9 or more	1.95 (1.42-2.68) *	1.32 (0.72-2.43)
Region
North	1.00	1.00
Northeast	0.85 (0.57-1.28)	2.85 (1.31-6.21) *
Southeast	0.61 (0.39-0.96) *	1.23 (0.57-2.62)
South	0.54 (0.30-0.98) *	0.75 (0.32-1.74)
Central	0.67 (0.40-1.11)	1.99 (0.81-4.87)
Household location
Urban	1.00	1.00
Rural	1.54 (1.06-2.22) *	0.87 (0.44-1.75)

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[1] Correspondence
M. F. Lima-Costa Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou, Fundação Oswaldo Cruz. Av. Augusto de Lima 1715, 6º andar, sala 614, Belo Horizonte, MG 30190-003, Brasil. lima.costa@fiocruz.br