Multimorbidity in the working-age population in Brazil: sociodemographic and behavioral factors
DOI:
https://doi.org/10.11606/s15188787.2026060007251Keywords:
Multimorbidity, Economically Active Population, Brazil, Health Survey, Epidemiological StudiesAbstract
OBJECTIVE: To assess the prevalence of multimorbidity in the Brazilian working-age population and analyze its determinants, with an emphasis on sociodemographic and behavioral aspects. METHODS: A cross-sectional study was conducted using data from the 2019 National Survey of Health, involving employed individuals aged 18 years or older. The outcome was multimorbidity, characterized by the simultaneous presence of two or more chronic noncommunicable diseases, based on a list of 14 conditions. Poisson regression with robust variance was used to assess the association between sociodemographic variables, habits, behaviors, and health/service outcomes. RESULTS: Among the 52,475 employed individuals, 22.6% (95%CI 21.9–23.2) had multimorbidity, which was more prevalent among: women; those aged 30 or older; those with lower levels of education; those who self-identified as white; and urban residents. Participation in public programs for physical activity, episodic heavy drinking, leisure-time screen time, self-rated health as fair/poor or very poor, a doctor’s visit in the past year, and having health insurance were also positively associated with multimorbidity. CONCLUSION: The findings highlight the significant prevalence of multimorbidity among the working-age population in Brazil, with particular emphasis on social and behavioral determinants. These results reinforce the importance of health promotion strategies in multiple contexts, including workplaces, communities, and primary care settings.
References
1. Amaral GSG, Ots P, Brouwer S, Van Zon SKR. Multimorbidity and exit from paid employment: The effect of specific combinations of chronic health conditions. Eur J Public Health. 2022;32:392-7. https://doi.org/10.1093/eurpub/ckac018
2. North TL, Harrison S, Bishop DC, Wootton RE, Carter AR, Richardson TG et al. Educational inequality in multimorbidity: causality and causal pathways: a mendelian randomisation study in UK Biobank. BMC Public Health. 2023;23. https://doi.org/10.1186/s12889-023-16369-1
3. Costa AK, Bertoldi AD, Fontanella AT, Ramos LR, Arrais PSD, Luiza VL et al. Does socioeconomic inequality occur in the multimorbidity among Brazilian adults? Rev Saúde Pública. 2020;54:1-12. https://doi.org/10.11606/s1518-8787.2020054002569
4. Petarli GB, Cattafesta M, Sant’Anna MM. Multimorbidity and complex multimorbidity in Brazilian rural workers. PLoS One. 2019;14(11): e0225416. https://doi.org/10.1371/journal.pone.0225416
5. Alcantara MA, Duarte ACM, Simões MRL, Barroso HH, Barbosa REC, Fonseca GC. Fatores associados a multimorbidades autorreferidas em trabalhadores da rede de saúde municipal. Rev Bras Saúde Ocup. 2023;48: e2. https://doi.org/10.1590/2317-6369/35120pt2023v48e2
6. Cabral GG, Souza ACD, Barbosa IR, Jerez-Roig J, Souza DLB. Multimorbidity and Its impact on workers: a review of longitudinal studies. Saf Health Work. 2019;10(4):393–9. https://doi.org/10.1016/j.shaw.2019.08.004
7. Nogueira FAM, Landmann CS, Damacena GN. Living and working conditions and access to health services for agricultural and non-agricultural workers, Brazil, 2013. Cienc Saúde Colet. 2021;26(Suppl 3):5187-200. https://doi.org/10.1590/1413-812320212611.3.21312019
8. Ministério da Saúde (BR). Plano de ações estratégicas para o enfrentamento das doenças crônicas e agravos não transmissíveis no Brasil 2021-2030. Brasília: Ministério da Saúde; 2021 [citado 2026 jul 9]. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/ publicacoes/svsa/doencas-cronicas-nao-transmissiveis-dcnt/09-plano-de-dant-2022_2030.pdf
9. Souza ASS. Multimorbidade e uso de serviços de saúde na população brasileira: pesquisa nacional de saúde 2019. Epidemiol Serv Saúde. 2023;32(3):e2023045. https://doi.org/10.1590/S2237-96222023000300007.en
10. Francisco PMSB, Assumpção D, Bacurau AGM, Silva DSM, Malta DC, Borim FSA. Multimorbidity and use of health services in the oldest old in Brazil. Rev Bras Epidemiol. 2021;24(Suppl 2):e210014. https://doi.org/10.1590/1980-549720210014.supl.2
11. Silveira ADS, Santos JEM, Cancela MC, Souza DLB. Estimated multimorbity among young Brazilians: results of the 2019 National Health Survey. Cienc Saúde Colet. 2023;28(9):2699-708. https://doi.org/10.1590/1413-81232023289.11842022
12. Instituto Brasileiro de Geografia e Estatística. Pesquisa nacional de saúde: 2019: questionário dos moradores do domicílio. Rio de Janeiro: IBGE; 2022 [citado 2026 jul 9]. Disponível em: https://biblioteca.ibge.gov.br/index.php/biblioteca-catalogo?view=detalhes&id=55569.
13. Stopa SR, Szwarcwald CL, Oliveira MM, Gouvea ECDP, Vieira MLFP, Freitas MPS et al. National health survey 2019: history, methods and perspectives. Epidemiol Serv Saúde. 2020;29(5):e2020315. https://doi.org/10.1590/S1679-49742020000500004
14. Malta DC, Bernal RTI, Vasconcelos NM, et al. Commuting and work-related accidents among employed brazilians, national survey of health 2013 and 2019. Rev Bras Epidemiol. 2023;26(Suppl 1):e230006. https://doi.org/10.1590/1980-549720230006.supl.1
15. World Health Organization. WHO guidelines on physical activity and sedentary behaviour. Geneva: WHO; 2020 [citado 2026 jul 9]. Disponível em: https://www.who.int/publications/i/ item/9789240015128
16. Mendes GFF, Häfele V, Blumenberg C, Werneck AO, Radicchi MR, Coll CVN et al. Comparação das estimativas de atividade física e comportamento sedentário em adultos brasileiros no VIGITEL e PNS, Brasil, 2013. Rev Bras Ativ Fis Saúde. 2018;23:1-10. https://doi.org/10.12820/rbafs.23e0062
17. Victora CG, Huttly SR, Fuchs SC, Olinto MT. The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J Epidemiol. 1997;26(1):224-7. https://doi.org/10.1093/ije/26.1.224
18. Ministério da Previdência Social (BR). Acompanhamento mensal do benefício auxílio por incapacidade temporária de natureza previdenciária e acidentária concedido segundo os códigos da CID-10 - Janeiro a Dezembro de 2025. Brasília: Ministério da Previdência Social; 2026 [citado 2026 jul 9]. Disponível em: https://www.gov.br/previdencia/pt-br/assuntos/ previdencia-social/saude-e-seguranca-do-trabalhador/acidente_trabalho_incapacidade/ quantidade-de-b31-por-cid-concessao-2025.pdf
19. Pires MP, Moreira CC, Andrade ACS, et al. Multimorbidity of chronic noncommunicable diseases: data from the Brazilian National Health Survey. Rev Chil Nutricion. 2023;50(1):7-19. https://doi.org/10.4067/S0717-75182023000100007
20. Pathirana TI, Jackson CA. Socioeconomic status and multimorbidity: a systematic review and meta-analysis. Aust N Z J Public Health. 2018;42(2):186-94. https://doi.org/10.1111/1753-6405.12762
21. Argentieri MA, Amin N, Nevado-Holgado AJ. Integrating the environmental and genetic architectures of aging and mortality. Nat Med. 2025;31:1016-25. https://doi.org/10.1038/s41591-024-03483-9
22. Oliveira FEG, Griep RH, Chor D, Giatti L, Machado LAC, Barreto SM et al. Racial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). BMC Public Health. 2022;22:1319. https://doi.org/10.1186/s12889-022-13715-7
23. Reyes-Ortiz CA, Lee T, Campo-Arias A, Ocampo-Chaparro JM, Luque JS. Racial discrimination and multimorbidity among older adults in Colombia: a national data analysis. Prev Chronic Dis. 2023;20:220360. https://doi.org/10.5888/pcd20.220360
24. Santos EMM, Andrade ACS, Portela DS, Bezerra VM. Awareness and participation in public physical activity programs among adults in the Northeast region of Brazil. Cienc Saúde Colet. 2025;30(5):e09822023. https://doi.org/10.1590/1413-81232025305.09822023
25. Sandy DD, Ferreira LB, Rodrigues BM. O impacto da rotina de pausas ativas no ambiente de trabalho na percepção de estresse, dor e qualidade do sono em trabalhadores administrativos. Braz J Lifest Med. 2023;2:1-24. https://doi.org/https://doi.org/10.61661/BJLM.2023.v2.76
26. Oliveira JL, Souza J. Fatores associados ao consumo de álcool entre trabalhadores públicos da manutenção. Acta Paul Enferm. 2018;31(1):17-24. https://doi.org/10.1590/1982-0194201800004
27. Gomes RS, Andrade ACS, Bezerra VM. Condução de veículos após o consumo de bebidas alcoólicas em residentes do nordeste do Brasil: pesquisa nacional de saúde 2019. Epidemiol Serv Saúde. 2024;33:e2024455. https://doi.org/10.1590/S2237-96222024v33e2024455.en
28. Prevalence of heavy episodic drinking in the Brazilian adult population: national health survey 2013 and 2019. Epidemiol Serv Saúde. 2022;31(spe 1):e2021379. https://doi.org/10.1590/SS2237-9622202200003.especial
29. Cardoso PC, Caldeira TCM, Sousa TM, Claro RM. Changes in screen time in Brazil: a time-series analysis 2016-2021. Am J Health Promot. 2023;37(5):681–4. https://doi.org/10.1177/08901171231152147
30. Paula D, Evenson KR, Feter N, Griep RH. Daily steps, activity, sedentary and sleep behaviors associations with all-cause mortality: the ELSA-Brasil study. Prev Med. 2025;192:108241. https:// 10.1016/j.ypmed.2025.108241
Published
Issue
Section
License
Copyright (c) 2026 Tamyres Araújo Andrade Donato, Amanda Cristina de Souza Andrade, Vanessa Moraes Bezerra

This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
Funding data
-
Conselho Nacional de Desenvolvimento Científico e Tecnológico
-
Fundação de Amparo à Pesquisa do Estado de Mato Grosso
Grant numbers 00022296/2025