Las enfermedades crónicas no transmisibles se consideran la pandemia del siglo XXI y constituyen un desafío de alta prioridad para la salud pública; de ahí el creciente interés en la vigilancia de los factores de riesgo de las enfermedades crónicas. Cuba desarrolla la vigilancia de los factores de riesgo de forma descentralizada en cada uno de sus municipios como parte de la estrategia para enfrentar las enfermedades no transmisibles. No tiene precedentes en Cuba la vigilancia descentralizada con este nivel de detalle y diseñada expresamente para informar a los decisores en el municipio y la provincia. Se describe la metodología empleada para planificar y realizar la medición de los principales factores de riesgo en 12 municipios de 10 provincias, como parte del sistema nacional de vigilancia de Cuba. Los resultados han facilitado el uso oportuno de la información y la toma de decisiones basadas en pruebas a nivel local.
PALABRAS CLAVE: Sistema de vigilancia, factores de riesgo de enfermedades no transmisibles, encuestas de salud, métodos para la encuesta, Cuba
Chronic non-communicable diseases have been called the pandemic of the 21st century and constitute a high-priority public health challenge; hence growing interest in chronic disease risk factor surveillance. Cuba is implementing decentralized risk factor surveillance in each of its municipalities as part of a strategy to address non-communicable diseases. Decentralized surveillance with this level of detail and explicitly designed to inform municipal and provincial decisionmaking is unprecedented in Cuba. We describe the methodology for planning and implementing measurement of major risk factors in 12 municipalities in 10 provinces, as part of Cuba’s National Surveillance System. The results have facilitated timely use of information and evidence-based decisionmaking at the local level.
KEYWORDS: Surveillance system, non-communicable disease risk factors, health surveys, survey methods, Cuba
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INTRODUCTION Tobacco and alcohol are currently the most widely consumed legal psychoactive substances in the world. They represent a heavy burden for health and society in almost all populations. Increasing consumption of both substances is a trend observed in women.
OBJECTIVE Describe the profile of women aged ≥15 years residing in urban areas of Cuba with respect to tobacco and alcohol consumption.
METHOD Basic information on tobacco and alcohol consumption by Cubans aged ≥15 years in urban areas was obtained from the Second National Survey on Risk Factors and Chronic Diseases (2001), a national descriptive cross-sectional study, the objective of which was to determine the frequency and epidemiological characteristics of the urban population’s main chronic disease risk factors. Sampling design was complex stratified multi-stage cluster. Of a sample of 23,743 individuals, 22,851 were surveyed, representative of 6.8 million Cubans. A questionnaire and structured interview were used. Variables were tobacco and alcohol use, as well as sociodemographic factors: sex, age, educational level, skin color, marital status, type of full-time employment and perceived economic situation. Prevalence, with 95% confidence intervals, and male:female prevalence ratios were estimated.
RESULTS Women who smoked were predominantlyaged 40–59 years; had completed less than university education; of black skin color; divorced; laborers, service workers or managers, and with a perceived economic situation as very poor. Women who consumed alcohol were predominantly aged 15–59 years, had at least middle school education, of mestizo or black skin color, of marital status other than widowed; there was no typical profile for occupation or perceived economic situation. Women who were both smokers and alcohol consumers were predominantly 20–59 years, of black or mestizo skin color, of marital status other than widowed; with no typical profile for educational level, occupation or perceived economic situation.
CONCLUSIONS The first nationwide socioeconomic profile of Cuban women using tobacco, alcohol or both constitutes a baseline for comparison to results of a new national study now under way, permitting evaluation of trends over time and effectiveness of prevention and control efforts.
KEYWORDS Risk behavior, risk factors, behavioral risk factor surveillance system, smoking, tobacco smoking, alcohol, alcohol consumption, psychoactive agents, prevalence, women’s health, Cuba
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