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While lifestyle factors are crucial for NCD prevention, evidence regarding their association with absenteeism in middle-income countries, such as Brazil, remains limited. In this context, the present study aims to analyze factors associated with the odds, duration, and costs of health-related absenteeism in S\u00e3o Paulo City, Brazil. Methods: Quantitative analysis was performed using microdata from the S\u00e3o Paulo Health Survey 2003, 2008, and 2015 (ISA-Capital). Logistic and negative binomial regression models identified factors associated with the odds and duration of health-related absenteeism. The human capital approach was used to estimate indirect costs (Int$ PPP), while two-part regression models (logit and generalized linear model) and average marginal effects (ME) identified cost-associated factors. Results: Tobacco use and NCD diagnoses (hypertension, type 2 diabetes, and cardiovascular diseases) significantly increased the odds and duration of absenteeism. Conversely, meeting recommended leisure-time physical activity levels was associated with lower indirect costs (ME = \u221233.94, p &lt; 0.05). Higher costs were significantly driven by tobacco use (ME = 48.68, p &lt; 0.01) and NCD, namely cardiovascular diseases (ME = 62.73), diabetes (ME = 55.18), hypertension (ME = 52.13), and obesity (ME = 36.45), all with p &lt; 0.05. Conclusions: Promoting leisure-time physical activity and tobacco cessation may be important strategies for public health policies aiming to enhance productivity by reducing the frequency, duration, and economic burden of health-related absenteeism, complementing the necessary diagnosis and monitoring of NCD.<\/jats:p>","DOI":"10.3390\/healthcare14101260","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T10:39:47Z","timestamp":1778150387000},"page":"1260","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated with the Odds, Duration, and Costs of Health-Related Absenteeism: A Population-Based Study in S\u00e3o Paulo City, Brazil"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6736-7139","authenticated-orcid":false,"given":"Lucas Akio Iza","family":"Trindade","sequence":"first","affiliation":[{"name":"School of Public Health, University of S\u00e3o Paulo, S\u00e3o Paulo 01246-904, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0009-1040","authenticated-orcid":false,"given":"Jaqueline Lopes","family":"Pereira","sequence":"additional","affiliation":[{"name":"School of Public Health, University of S\u00e3o Paulo, S\u00e3o Paulo 01246-904, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0517-1645","authenticated-orcid":false,"given":"Marcelo Macedo","family":"Rogero","sequence":"additional","affiliation":[{"name":"School of Public Health, University of S\u00e3o Paulo, S\u00e3o Paulo 01246-904, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4490-9035","authenticated-orcid":false,"given":"Regina Mara","family":"Fisberg","sequence":"additional","affiliation":[{"name":"School of Public Health, University of S\u00e3o Paulo, S\u00e3o Paulo 01246-904, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2834-2005","authenticated-orcid":false,"given":"Flavia Mori","family":"Sarti","sequence":"additional","affiliation":[{"name":"School of Arts, Sciences and Humanities, University of S\u00e3o Paulo, S\u00e3o Paulo 03828-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.puhe.2024.09.006","article-title":"Noncommunicable Disease Burden in Brazil and Its States from 1990 to 2021, with Projections for 2030","volume":"236","author":"Malta","year":"2024","journal-title":"Public Health"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Wang, Y., and Wang, J. 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