Clustering of unhealthy behaviors in a Brazilian population of industrial workers

Objective: To analyze the clustering of four unhealthy behaviors (tobacco use, excessive alcohol consumption, physical inactivity and low consumption of fruits and vegetables) and their association with sociodemographic factors among adult industrial workers in Brazil. Methods: Data from 23 Brazilian states and the Federal District were collected via questionnaire from 2006 to 2008. Clustering of risk behaviors was identified using the ratio between the observed and expected percentages of each combination of unhealthy behaviors. Results: Among the 44,477 workers surveyed, 18.0% of men and 11.4% of women accumulated three or four unhealthy behaviors. The most frequent combination was physical inactivity and low consumption of fruits and vegetables. The concurrent presence of all four behaviors was 86% higher in men and 148% higher in women than would be predicted if the frequency of these behaviors were independent. Presence of one or more negative behaviors was more frequent in men, younger individuals and in those with lower levels of education and family income than subjects without these characteristics. Conclusions: There was a strong tendency for unhealthy behaviors to assume combinatorial patterns, mainly in men, people with less education, income, and age, suggesting important disparities.