Discriminação percebida e atividade física entre adolescentes de uma capital do nordeste brasileiro

Abstract

Introduction: Discrimination represents an important risk factor for physical and mental health, by acting through mechanisms that lead to access to health goods, services and practices. Among adolescents, the effects of discrimination can have repercussions both in the current and future stages of life, by affecting adherence to health protection factors such as the practice of physical activity. Objective: This research investigated the prevalence and factors associated with perceived discrimination, and the effects of this discrimination on physical activity among adolescents in the city of São Luís - MA. Methods: Cross-sectional study with data from 2,484 adolescents (18 and 19 years old) from the São Luís, Maranhão, cohort evaluated in 2016. Prevalence was estimated for six types of discrimination (race, sex, religion, sexual preference, disease/disability or income), and according to socioeconomic, demographic, lifestyle and health assessment variables. The association between the variables of interest and discrimination was estimated using Poisson regression models, in which Prevalence Ratios (PR) and 95% Confidence Intervals (CI95%) were presented. Structural Equation Modeling was also used to verify the direct effect of discrimination on the practice of physical activity, measured through the International Physical Activity Questionnaire (IPAQ) and the indirect effect mediated by Common Mental Disorders (CMD). This was used in modeling as a mediating variable and was measured using the Self-Reporting Questionnaire (SRQ-20). Associations were verified using Standardized Coefficients (SC) and p-value (α = 0.05). Results: The prevalence of discrimination by the one of the types evaluated was 26.2%. The highest were: religion (12.3%), race (9.7%) and sex (6.3%). In the adjusted analysis, there was a greater chance of discrimination between females (PR: 1.37; CI95%: 1.16-1.64), blacks (PR: 1.58; CI95%: 1.24-2 , 01), evangelical religions (PR: 1.26; CI95%: 1.04-1.52), spiritualist (RP: 2.55; CI95%: 1.13-5.80), umbandista/candomblecista ( PR: 3.51; CI95%: 1.12-12.03), unsafe in the neighborhood (PR: 1.30; CI95%: 1.06-1.59), alcohol risk consumption (PR: 1, 36; CI95%: 1.09-1.70), current use of illicit drugs (PR: 1.46; CI95%: 1.05-2.02) and worse health satisfaction (dissatisfied: PR: 1.44; CI95%: 1.15-1.80; and regular: PR: 1.20; CI95%: 1.08- 1.54) and less chance among those who neither work nor study (PR: 0.82; CI95% : 0.68-0.99). Discrimination was associated with higher levels of physical activity in women (SCdirect = 0.105, p-value = 0.005), and associated with lesser physical activity indirectly through the CMD among men (SCindirect = -0.024, p-value = 0.017) and women (SCindirect = -0.024, p-value = 0.015).Conclusion: High prevalence and factors associated with discrimination were observed among adolescents, and this was directly associated with physical activity among women and the CMD mediated the relationship between these variables between men and women, pointing out that their exposure can affect health behaviors in one period when social pressures and bodily changes already affect the physical and mental health of adolescents.