Fifteen-Year Trends in Behavioral Risk Factors and Metabolic Health Conditions for Non-Communicable Diseases: Persistent Race and Gender Inequalities in Brazil

Non-communicable diseases (NCDs) are the leading cause of death worldwide and disproportionately affect certain demographic groups due to structural inequalities. In Brazil, racial and gender disparities influence the distribution of risk and protective factors for NCDs. To analyze time trends (2009–2023) in modifiable behavioral risk factors (alcohol abuse, smoking, physical activity, and vegetable consumption) and metabolic conditions (obesity, diabetes, and hypertension) for NCDs, stratified by race and gender. Time-series study using data from adults residing in the 26 Brazilian state capitals and the Federal District, collected by the VIGITEL telephone surveillance system. Trends were analyzed using Prais–Winsten linear regression. Alcohol abuse increased over time, especially among women, particularly Black women. Smoking decreased significantly, most notably among Black men, although prevalence remained higher among men. Physical activity rose in all subgroups, especially among women, while vegetable consumption remained stable. Obesity increased in all subgroups, especially among Black women and White men. Diabetes prevalence increased, with the highest rates among White women. Hypertension showed no significant change. Despite positive trends in smoking and physical activity, racial and gender disparities remain. Black women experienced higher increases in obesity and face more barriers to physical activity. White women had the highest diabetes prevalence. Men showed greater reductions in smoking. These findings underscore the need for policies that address race- and gender-specific disparities in NCDs to promote health equity in Brazil.