Prevalence of chronic non-communicable diseases and multimorbidity among adults living in slums in Rio de Janeiro, Brazil: a population-based survey.

Abstract

Background: Multimorbidity accounts for 77% of overall mortality in low- and middle-income countries, with scarce prevalence estimates among populations living in slums. This study aims to estimate the prevalence and factors associated with chronic non-communicable diseases (CNCD) and multimorbidity among adults living in a large slum complex in the city of Rio de Janeiro, Brazil.

Methods: Adults aged 18 or older who resided in the Manguinhos slum complex and participated in a cross-sectional study conducted between September 15, 2020, and February 10, 2021 were included in the analyses. We estimated the prevalence of self-reported CNCD by gender and age strata. Multimorbidity was defined as the presence of at least two CNCD. Logistic regression models were used to assess the association of demographic and behavioral variables with multimorbidity.

Results: Of 3,119 participants, 37% were cisgender men and 63% cisgender women, most participants were aged between 45-64 years (36.4%). High blood pressure was the most common CNCD reported by men (29.7%) and women (36.3%), followed by obesity (men: 19%, women: 25.6%) and diabetes mellitus (men: 13.1%, women: 12.4%). We identified multimorbidity in 21.5% of men and 31% of women, older participants and those self-identified as Pardo or Black had higher odds of multimorbidity regardless of gender, women with private health insurance and reporting tobacco smoking had higher odds of multimorbidity.

Conclusion: Our findings showed a high burden of CNCD and multimorbidity among people living in slums in a large metropolitan area in Latin America, highlighting an ongoing "neglected epidemic" that affect a substantial part of the urban population exposed to precarious living conditions and socioeconomic vulnerability.