Multimorbidity and health care of community health workers in Vitória, Espírito Santo, Brazil, 2019: a cross-sectional study

Martins, Haysla Xavier; Siqueira, Jordana Herzog; Oliveira, Ana Maria Abreu de; Jesus, Hanna Carolina de; Pereira, Taísa Sabrina Silva; Sichieri, Rosely; Mill, José Geraldo; Molina, Maria del Carmen Bisi

Haysla Xavier Martins

Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brazil

http://orcid.org/0000-0001-8827-1793

Jordana Herzog Siqueira

Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brazil

http://orcid.org/0000-0003-0116-7411

Ana Maria Abreu de Oliveira

Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brazil

http://orcid.org/0000-0001-6955-5918

Hanna Carolina de Jesus

Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Nutrição e Saúde, Vitória, ES, Brazil

http://orcid.org/0000-0002-4585-5913

Taísa Sabrina Silva Pereira

Universidad de las Américas Puebla, Ciencias de la Salud, San Andrés Cholula, PUE, Mexico

http://orcid.org/0000-0002-5922-7424

Rosely Sichieri

Universidade do Estado do Rio de Janeiro, Instituto de Medicina Social, Rio de Janeiro, RJ, Brazil

http://orcid.org/0000-0001-5286-5354

José Geraldo Mill

Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brazil

http://orcid.org/0000-0002-0987-368X

Maria del Carmen Bisi Molina

Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Saúde Coletiva, Vitória, ES, Brazil

http://orcid.org/0000-0002-8614-988X

Correspondence
Maria del Carmen Bisi Molina mdcarmen2007@gmail.com

Associate editor

Bruno Pereira Nunes

Authors’ contribution

Molina MCB, Sichieri R and Mill JG contributed to preparing the study and its design. De Jesus HC and De Oliveira AMA contributed to data acquisition. Martins HX contributed to data acquisition, analysis and interpretation. Siqueira JH and Pereira TSS contributed to drafting and/or reviewing the manuscript. All authors have approved the final version and are responsible for all aspects thereof, including the guarantee of its accuracy and integrity.

Conflicts of Interest

The authors declared that they have no conflicts of interest.

Variables	Total	Sex		p-value	Age group (years)		p-value
	Total	Female	Male		<45	≥45
	n (%)	n (%)	n (%)		n (%)	n (%)
	262	247 (94.3)	15 (5.7)		130 (49.6)	132 (50.4)
Age (years)^a	46.1±9.3	46.4±9.2	40.6±8.6	0.023^b	38.2±3.8	53.8±5.9	<0.001^b
Race/skin color				0.774^d			0.012^c
White	49 (18.7)	47 (19.0)	2 (13.3)		18 (13.8)	31 (23.5)
Black	82 (31.3)	76 (30.8)	6 (40.0)		51 (39.2)	31 (23.5)
Brown	131 (50.0)	124 (50.2)	7 (46.7)		61 (46.9)	70 (53.0)
Schooling				0.418^d			0.034^d
Complete elementary education	11 (4.2)	10 (4.0)	1 (6.7)		6 (4.6)	5 (3.8)
Complete high school education	213 (81.3)	202 (81.8)	11 (73.3)		98 (75.4)	115 (87.1)
Complete higher education	38 (14.5)	35 (14.2)	3 (20.0)		26 (20.0)	12 (9.1)
Currently studying	27 (10.3)	23 (9.3)	4 (26.7)	0.055^d	22 (16.9)	5 (3.8)	<0.001^d
Socioeconomic class				0.473^d			0.547^d
A and B	103 (39.3)	95 (38.5)	8 (53.3)		47 (36.2)	56 (42.4)
C	154 (58.8)	147 (59.5)	7 (46.7)		81 (62.3)	73 (55.3)
D and E	5 (1.9)	5 (2.0)	-		2 (1.5)	3 (2.3)
Marital status				0.015^d			<0.001^c
Single	45 (17.2)	38 (15.4)	7 (46.7)		32 (24.6)	13 (9.8)
Married	174 (66.4)	167 (67.6)	7 (46.7)		87 (66.9)	87 (65.9)
Separated or widowed	43 (16.4)	42 (17.0)	1 (6.7)		11 (8.5)	32 (24.3)

Variables	Total	Sex		p-value	Age group (years)		p-value
	Total	Female	Male		<45	≥45
	n (%)	n (%)	n (%)		n (%)	n (%)
	262	247 (94.3)	15 (5.7)		130 (49.6)	132 (50.4)
Self-perceived health status				0.210^d			0.736^d
Very good	44 (16.8)	39 (15.8)	5 (33.3)		24 (18.5)	20 (15.2)
Good	136 (51.9)	129 (52.2)	7 (46.7)		65 (50.0)	71 (53.8)
Regular, poor or very poor	82 (31.3)	79 (32.0)	3 (20.0)		41 (31.5)	41 (31.0)
Tobacco smoking	10 (3.8)	8 (3.2)	2 (13.3)	0.100^d	1 (0.8)	9 (6.8)	<0.001^d
Alcoholic beverage consumption	111 (42.4)	101 (40.9)	10 (66.7)	0.050^c	58 (44.6)	53 (40.2)	0.465^c
Physical activity^a				0.166^d			0.372^c
Active	76 (29.1)	69 (28.0)	7 (46.7)		43 (33.1)	33 (25.2)
Insufficiently active	26 (10.0)	24 (9.8)	2 (13.3)		12 (9.2)	14 (10.7)
Sedentary	159 (60.9)	153 (62.2)	6 (40.0)		75 (57.7)	84 (64.1)
Physical activity (minutes/week)^b	107.6±174.1	103.2±169.9	179.3±228.3	0.099^f	123.9±187.5	91.4±158.8	0.195^f
Screen time (hours/day)^b	3.6±2.2	3.6±2.2	3.8±1.8	0.473^f	3.9±2.2	3.3±2.2	0.021^f
Time spent sitting (hours/day)^b	3.7±1.9	3.7±1.9	4.2±1.9	0.001^e	3.9±1.9	3.6±1.9	0.007^e
Diabetes mellitus	45 (17.2)	42 (17.0)	3 (20.0)	0.727^d	14 (10.8)	31 (23.5)	0.006^c
Hypertension	97 (37.0)	91 (36.8)	6 (40.0)	0.806^c	29 (22.3)	68 (51.5)	<0.001^c
Hypercholesterolemia (≥190 mg/dL)	150 (57.3)	145 (58.7)	5 (33.3)	0.063^d	60 (46.2)	90 (68.2)	<0.001^c
Hypertriglyceridemia (≥150 mg/dL)	71 (27.1)	68 (27.5)	3 (20.0)	0.766^d	27 (20.8)	44 (33.3)	0.022^c
Nutritional status^a				0.562^d			0.677^c
Normal and low weight	68 (26.1)	63 (25.6)	5 (33.3)		37 (28.4)	31 (23.7)
Overweight	89 (34.1)	83 (33.7)	6 (40.0)		43 (33.1)	46 (35.1)
Obesity	104 (39.8)	100 (40.7)	4 (26.7)		50 (38.5)	54 (41.2)
Abdominal obesity	132 (50.4)	128 (51.8)	4 (26.7)	0.067^d	59 (45.4)	73 (55.3)	0.138^c
Metabolic syndrome	79 (30.2)	75 (30.4)	4 (26.7)	1.000^d	26 (20.0)	53 (40.2)	<0.001^c

Variables	Total	Sex		p-value	Age group (years)		p-value
	Total	Female	Male		<45	≥45
	(n=262)	(n=247)	(n=15)		(n=130)	(n=132)
Colesterol total (mg/dL)^a	198.9±37.7	200.1±38.0	180.3±27.7	0.049^c	188.4±31.5	209.3±40.5	<0.001^c
HDL-colesterol (mg/dL)^b	48.5 (43.0;58.0)	49.0 (43.0;58.0)	42.0 (36.0;49.0)	0.004^d	49.0 (42.7;59.2)	48.0 (43.0;56.7)	0.388^d
LDL-colesterol (mg/dL)^a	121.7±35.0	122.4±35.5	110.8±23.0	0.209^c	111.6±28.0	131.6±38.2	<000.1^c
Triglicerídeos (mg/dL)^b	114.5 (85.7;154.2)	115.0 (85.0;155.0)	111.0 (93.0;144.0)	0.911^d	103.5 (81.5;140.0)	99.0 (92.0;110.0)	0.008^d
Glicemia em jejum (mg/dL)	96.0 (88.0;105.0)	96.0 (88.0;105.0)	96.0 (92.0;104.0)	0.606^d	92.0 (86.0;100.0)	11.6 (7.6;18.3)	0.606^d
Insulina (mcUI/mL)^b	12.0 (8.1;18.3)	12.1 (8.3;18.4)	8.8 (5.4;17.1)	0.256^d	12.6 (8.8;19.0)	2.8 (1.7;4.6)	0.851^d
Índice HOMA-IR^b	2.9 (1.8;4.4)	2.9 (1.8;4.4)	1.0 (1.2;4.0)	0.287^d	2.9 (1.8;4.3)	122.0 (91.5;165.7)	0.274^d
Peso corporal (kg)^a	74.8±15.5	74.4±15.6	80.7±13.9	0.133^c	75.4±15.4	74.2±15.6	0.489^c
IMC (kg/m2)^a	28.9±5.5	29.0±5.5	26.8±4.8	0.125^c	28.6±5.5	29.2±5.4	0.386^c
PGC (%)^a	38.0±8.5	39.1±7.1	20.4±10.8	<0.001^c	36.9±8.4	39.0±8.6	0.047^c
CC (cm)^a	90.8±14.8	90.8±14.8	90.2±14.7	0.881^c	88.9±13.8	92.7±15.5	0.040^c
PAS (mmHg)^b	113.5 (105.5;123.1)	114.0 (105.5;123.0)	113.0 (110.5;136.5)	0.302^d	110.5 (104.5;118.0)	117.2 (109.0;127.3)	0.302^d
PAD (mmHg)^a	74.6±9.4	74.5±9.0	76.9±14.7	0.346^c	74.6±9.5	74.7±9.4	0.907^c

Variables	n^a	%
Diseases
Classified as having diabetes mellitus without prior diagnosis	10	22.2
Classified as having hypertension without prior diagnosis	9	9.3
Controlled diabetes mellitus^b	15	33.3
Controlled hypertension^c	71	73.2
Medication use
Antidiabetics	33	12.6
Antihypertensives	84	32.1
Hypolipidemics	20	7.6
Anxiolytics and/or antidepressives	59	22.5
For gastric problems	39	14.9

[1] Correspondence
Maria del Carmen Bisi Molina mdcarmen2007@gmail.com

Brasil

Brasil

Multimorbidity and health care of community health workers in Vitória, Espírito Santo, Brazil, 2019: a cross-sectional study

Abstract

Objective

Methods

Results

Conclusion