Examining the association of sociodemographic characteristics on self-reported changes in health-related behaviors, mental health, and quality of life during the COVID-19 pandemic in Brazil

Background: The challenges faced during COVID-19 for the public health were unprecedent in the last 100 years. The necessity to adapt lifestyles during this period highlighted inequalities in health-related behaviors, quality of life and mental health of the population, especially in unequal countries like Brazil. Aim: To analyze the associations of sociodemographic characteristics and recalled changes in health-related behavior, mental health, and quality of life during the COVID-19 pandemic Brazil. Methods: Quantitative, web-based representative survey study of Brazilian adults (≥ 18 years). Sampling procedures proportionally considered state population and characteristics to complete quotas based on gender, age group, and socioeconomic status. Health-related outcomes included changes, from before the COVID-19 pandemic to during the COVID-19 pandemic, in habitual physical activity (no change, decrease and, increase), diet behaviors (no change, growth), quality of life (no change, decrease and, increase), and mental health tertile (4–6, 7–9 and 10–16). Variables used to characterize inequalities included gender (male/female), race (white, black, pardo and, other), and educational attainment (less than high school, high school and, higher education). Frequency distribution and multinomial regression were performed with SPSS 23.0 with a significance level 0.05. Results: Most participants changed physical activity behaviors (77.5%), diet (56.5%), and perceived quality of life (37.9%). Women were less likely to decrease their physical activity, quality of life, and mental health. Among ethnic groups, blacks were less likely to increase unhealthy food consumption. Finally, groups with less than a high school education were more likely to have an unhealthy diet and lower odds of negative mental health scores. Conclusion: Being a woman, black, or having lower educational attainment was found to be associated with changes in health-related behaviors during the COVID-19 pandemic in Brazil, underscoring the contribution of COVID-19 to widening health inequities.