Determinants of self-perceived health in schoolchildren: Analysis from the 2019 National School Health Survey (PeNSE).

This study assessed the prevalence and factors associated with negative self-perceived health among adolescents aged 13 to 17 years. A cross-sectional design was used with data from the 2019 National School Health Survey (PeNSE). The outcome variable was self-perceived health, while family, sociodemographic, and behavioral characteristics were considered exposure variables. Prevalence Ratios (PR) and 95% Confidence Intervals (95% CI) were estimated using Poisson regression with a hierarchical model, stratified by sex. The prevalence of negative health perception was 32.2%, with a higher prevalence among females than males (PR: 1.72; 95% CI: 1.68-1.76). Among adolescents who reported smoking tobacco cigarettes in the past month, the PR for negative health perception was 1.11 (95% CI: 1.07-1.16) in females and 1.18 (95% CI: 1.08-1.27) in males. Engagement in physical activity on four or more days in the past week was associated with a lower prevalence of negative health perception in both sexes (PR: 0.55 [95% CI: 0.52-0.58] in males and PR: 0.79 [95% CI: 0.76-0.82] in females).

conclusionIn summary, approximately one-third of adolescents reported a negative perception of their health. Smoking was associated with a higher prevalence of the outcome, whereas physical activity was protective in both sexes. WHAT IS KNOWN: • Self-perceived health is a widely used and reliable health indicator in national surveys, yet few Brazilian studies have examined negative self-perceived health in adolescents, and none with nationally representative data. WHAT IS NEW: • This study uses a nationally representative sample of adolescents, incorporating a broader range of behavioral and social factors. • The stratified analysis by sex provides an additional contribution, highlighting differences in associated factors between males and females.