Demand for health services or professionals among Brazilian adolescents according to the National School Health Survey 2015

Oliveira, Max Moura de; Andrade, Silvânia Suely Caribé de Araújo; Stopa, Sheila Rizzato; Malta, Deborah Carvalho

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Revista Brasileira de Epidemiologia

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Sumário

ORIGINAL ARTICLE • Rev. bras. epidemiol. 21 (suppl 1) • 2018 • https://doi.org/10.1590/1980-549720180003.supl.1 copy

Demand for health services or professionals among Brazilian adolescents according to the National School Health Survey 2015

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT:

Introduction:

Knowing the profile of individuals who demand health services or professionals could help in the improvement and reorganization of services. However, this subject is still underexplored among adolescents. This study aimed to describe and identify characteristics related to the demand for health services or professionals by Brazilian students.

Methods:

Using data from the 2015 National School Health Survey, the prevalence and respective 95% confidence intervals (95%CI) of the demand for health services or professionals among students were estimated, and Poisson regression adjusted by age and region of residence was used to identify the associated factors.

Results:

More than half of the students demanded for health services or professionals in the last year, with a higher demand among females. The characteristics associated with the outcome were sociodemographic (female, white, private school), family (maternal schooling of 12 years or more, having meals with parents/guardians and parents’ knowledge of the adolescent’s activities in their free time), risk behaviors (alcohol consumption and sexual intercourse without a condom) and health-related issues (physical violence, wheezing, toothache, hygiene habits, and attitude to one’s own weight).

Conclusion:

Organizing health services in a way that takes the particularities of this population into account may provide a space to deal with subjects related to the risks to which it is exposed.

Keywords:
School health; Adolescent behavior; Adolescent; Health services

Variables	% (95%CI)
Sex (n = 10,813)
Female	61.1 (59.2 - 63.0)
Male	52.4 (50.4 - 54.3)
Age (years) (n = 10,813)
13	51.8 (48.6 - 55.1)
14	53.9 (50.8 - 57.0)
15	57.5 (54.6 - 60.4)
16	63.6 (60.9 - 66.2)
17	56.7 (53.1 - 60.2)
Race/skin color (n = 10,806)
White	60.4 (58.4 - 62.3)
Black	52.2 (48.6 - 55.7)
Yellow	53.3 (47.5 - 59.1)
Brown	55.8 (53.2 - 58.3)
Indigenous	52.2 (44.9 - 59.4)
School type (n = 10,813)
Private	69.9 (67.5 - 72.2)
Public	54.8 (53.1 - 56.4)
Region of residence (n = 10,813)
North	53.8 (51.0 - 56.5)
Northeast	53.7 (50.5 - 56.9)
Southeast	59.6 (57.1 - 62.2)
South	56.5 (53.3 - 59.7)
Midwest	56.4 (53.3 - 59.5)
Maternal schooling (n = 8,484)
Illiterate	48.6 (43.7 - 53.5)
Primary Education	56.0 (53.3 - 58.7)
Secondary Education	62.2 (59.7 - 64.6)
Higher Education	65.3 (62.4 - 68.0)
Living with at least one of the parents at the same house (n = 10,807)
Neither parent	54.9 (50.7 - 59.1)
Only with the mother or father	54.3 (52.2 - 56.3)
Both parents	58.5 (56.4 - 60.6)
Meal with parents or guardians (n = 10,802)
No	53.7 (51.1 - 56.4)
Yes	57.6 (56.0 - 59.3)
Missing classes without permission from parents or guardians (n = 10,799)
No	57.7 (55.8 - 59.5)
Yes	54.2 (51.7 - 56.7)
Knowledge of parents or guardians about their children’s activities in their free time (n = 10,790)
Never/rarely	48.8 (46.0 - 51.7)
Sometimes	51.7 (48.2 - 55.2)
Most times/always	60.3 (58.8 - 61.8)
Current smoking (n = 10,810)
No	56.7 (55.1 - 58.3)
Yes	57.5 (52.3 - 62.5)
Current alcohol abuse (n = 10,802)
No	54.4 (52.7 - 56.1)
Yes	62.4 (60.0 - 64.7)
Current drug use (n = 10,809)
No	56.4 (53.3 - 56.9)
Yes	63.2 (56.4 - 61.3)
Sexual behavior in last intercourse (n = 10,798)
Did not have intercourse	55.1 (53.5 - 56.6)
With condom	58.8 (56.2 - 61.4)
Without condom	60.4 (57.0 - 63.7)
Having had an injury (n = 10,769)
No	56.2 (54.5 - 57.9)
Yes	60.8 (57.4 - 64.1)
Having suffered physical violence in the last 12 months (n = 10,781)
No	55.3 (53.6 - 57.1)
Yes	63.7 (61.0 - 66.3)
Feeling alone (n = 10,801)
Never/rarely	52.3 (49.8 - 54.8)
Sometimes	59.8 (57.9 - 61.7)
Most of the time/Always	56.0 (52.2 - 59.8)
Chest wheezing (n = 10,773)
No	54.2 (52.5 - 56.0)
Yes	66.2 (63.8 - 68.5)
Toothache (n = 9,727)
No	56.2 (54.4 - 58.1)
Yes	59.5 (56.6 - 62.2)
Habit of washing hands (n = 10,786)
No	53.0 (50.8 - 55.2)
Yes	58.8 (57.1 - 60.5)
Attitude towards body weight (n = 10,765)
Does nothing	51.2 (48.8 - 53.5)
Losing weight	61.4 (58.9 - 63.8)
Gaining weight	59.0 (56.0 - 62.0)
Maintaining weight	60.9 (57.7 - 63.9)
Self-assessment of health status (n = 10,795)
Very good	54.1 (51.5 - 56.6)
Good	58.6 (56.4 - 60.8)
Regular	57.0 (54.4 - 59.7)
Bad	59.8 (53.2 - 66.2)
Too bad	61.0 (54.8 - 66.8)
Total	56.7% (55.2 - 58.3)

Variables	PR (95%CI)	p-value	PR_a (95%CI)*	p-value
Sex
Female	Reference		Reference
Male	0.86 (0.82 - 0.89)	< 0.001	0.86 (0.82 - 0.91)	< 0.001
Age (in years)	1.04 (1.02 - 1.06)	< 0.001	-	-
Race/skin color
White	Reference		Reference
Black	0.86 (0.80 - 0.93)	< 0.001	0.86 (0.79 - 0.94)	< 0.001
Yellow	0.88 (0.79 - 0.99)	0.033	0.87 (0.78 - 0.99)	0.029
Brown	0.92 (0.87 - 0.98)	0.006	0.96 (0.90 - 1.01)	0.129
Indigenous	0.86 (0.75 - 1.00)	0.048	1.00 (0.85 - 1.17)	0.988
School type
Private	Reference		Reference
Public	0.78 (0.75 - 0.82)	< 0.001	0.87 (0.82 - 0.93)	< 0.001
Region of residence
North	Reference		-	-
Northeast	1.00 (0.92 - 1.08)	0.977	-	-
Southeast	1.11 (1.04 - 1.19)	0.002	-	-
South	1.05 (0.97 - 1.13)	0.197	-	-
Midwest	1.05 (0.97 - 1.13)	0.205	-	-
Maternal schooling
Illiterate	Reference		Reference
Primary Education	1.15 (1.03 - 1.29)	0.011	1.09 (0.97 - 1.22)	0.167
Secondary Education	1.28 (1.15 - 1.42)	< 0.001	1.19 (1.06 - 1.34)	0.003
Higher Education	1.34 (1.20 - 1.50)	< 0.001	1.21 (1.07 - 1.38)	0.002
Living with at least one of the parents at the same house
Neither parent	Reference		-	-
Only with the mother or father	0.99 (0.91 - 1.08)	0.782	-	-
Both parents	1.07 (0.98 - 1.16)	0.154	-	-
Meal with parents or guardians
No	Reference		Reference
Yes	1.07 (1.02 - 1.13)	0.010	1.09 (1.02 - 1.16)	0.015
Missing classes without permission from parents or guardians
	Reference		-	-
Yes	0.94 (0.89 - 0.99)	0.027	-	-
Knowledge of parents or guardians about their children’s activities in their free time
Never/rarely	Reference		Reference
Sometimes	1.06 (0.97 - 1.16)	0.202	1.01 (0.91 - 1.13)	0.202
Most times/always	1.23 (1.16 - 1.32)	< 0.001	1.19 (1.10 - 1.28)	< 0.001
Current smoking
No	Reference		-	-
Yes	1.01 (0.92 - 1.11)	0.771	-	-
Current alcohol abuse
No	Reference		Reference
Yes	1.15 (1.10 - 1.20)	< 0.001	1.10 (1.05 - 1.16)	< 0.001
Current drug use
No	Reference		-	-
Yes	1.12 (1.02 - 1.23)	0.013	-	-
Sexual behavior in last intercourse
Did not have intercourse	Reference		Reference
With condom	1.07 (1.02 - 1.11)	0.002	1.01 (0.95 - 1.07)	0.821
Without condom	1.10 (1.03 - 1.17)	0.007	1.09 (1.01 - 1.17)	0.018
Having had an injury
No	Reference		-	-
Yes	1.08 (1.02 - 1.15)	0.013	-	-
Having suffered physical violence in the last 12 months
No	Reference		Reference
Yes	1.15 (1.10 - 1.21)	< 0.001	1.09 (1.02 - 1.16)	0.007
Feeling alone
Never/rarely	Reference		-	-
Sometimes	1.14 (1.08 - 1.21)	< 0.001	-	-
Most of the time/Always	1.07 (0.99 - 1.15)	0.078	-	-
Chest wheezing
No	Reference		Reference
Yes	1.22 (1.17 - 1.28)	< 0.001	1.15 (1.09 - 1.20)	< 0.001
Toothache
No	Reference		Reference
Yes	1.06 (1.00 - 1.12)	0.057	1.07 (1.01 - 1.14)	0.018
Habit of washing hands
No	Reference		Reference
Yes	1.11 (1.06 - 1.16)	< 0.001	1.09 (1.03 - 1.15)	< 0.001
Attitude towards body weight
Does nothing	Reference		Reference
Losing weight	1.20 (1.13 - 1.27)	< 0.001	1.09 (1.03 - 1.17)	0.005
Gaining weight	1.15 (1.08 - 1.23)	< 0.001	1.10 (1.03 - 1.18)	0.004
Maintaining weight	1.19 (1.12 - 1.26)	< 0.001	1.16 (1.09 - 1.23)	< 0.001
Self-assessment of health status
Very good	Reference		-	-
Good	1.08 (1.02 - 1.15)	0.009	-	-
Regular	1.05 (0.99 - 1.12)	0.097	-	-
Bad	1.11 (0.98 - 1.25)	0.101	-	-
Very bad	1.13 (1.02 - 1.25)	0.023	-	-

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[1] Corresponding author: Max Moura de Oliveira. Rua Taguá, 440, Liberdade, CEP: 01508-010, São Paulo, SP, Brasil. E-mail: maxomoura@gmail.com