Educational inequalities in sun protection practices among Brazilian adults

Excessive exposure to ultraviolet (UV) radiation is a major risk factor for skin cancer, yet sun protection behaviors vary widely across different populations. This study examines the association between sun protection behaviors and educational attainment among Brazilian adults. A cross-sectional study was conducted using data from the Brazilian Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel) from 2007 to 2010. Sun protection behaviors were assessed based on self-reported habitual avoidance of sun exposure, use of sunscreen, hats/umbrellas, and protective clothing. Educational attainment was analyzed as the main explanatory variable, along with other sociodemographic and behavioral factors. Poisson regression models with robust variance estimation were used to identify factors associated with sun protection practices. Nearly half of the population reported not using any form of sun protection, with prevalence ranging from 45.9% (2007) to 52.5% (2010). Sunscreen was the most commonly used method (38.2% in 2010), followed by hats or umbrellas (7.2%), those who do not usually expose themselves to the sun (3.7%), and 1.2% reporting combined use of appropriate clothing. Women, older individuals, and those with higher educational attainment were more likely to use sun protection. Higher education was associated with greater sunscreen use, but less sun avoidance and protective clothing (PRs: 2.63, 0.71, and 0.70, respectively). This study demonstrates that educational attainment is a determinant of sun protection behaviors among Brazilian adults. Individuals with higher education are significantly more likely to use sunscreen, while those with lower education levels report greater use of physical barriers or avoidance of sun exposure.