RESUMO
This study investigated the association of the intersectional categories of gender-race/color with inadequate blood pressure (BP) control in Brazilian adults using antihypertensive drugs to treat hypertension. This is a cross-sectional analysis conducted with 4448 participants living with hypertension from visit 2 (2012-2014) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) undergoing pharmacological treatment. The association of the intersectional categories - White woman, Brown woman, Black woman, White man, Brown man, Black man - with inadequate BP control (systolic BP levels ≥140 mmHg and/or diastolic BP levels ≥90mmH) was estimated by the prevalence ratio (PR) and 95% confidence interval (95% CI) obtained by generalized linear models with Poisson distribution, adjusted covariates. The age-standardized prevalence of inadequate BP control ranged from 18.9% (White women) to 35.6% (Black men). After adjusting for sociodemographic characteristics, health-related behavior, health conditions, and the class number of antihypertensive medications, compared to White women, Black men (PR: 1.49 95% CI: 1.26-1.75), Brown men (PR: 1.42 95% CI: 1.18-1.72), Black women (PR: 1.36 95% CI: 1.12-1.65), and White men (PR: 1.32 95% CI: 1.09-1.60) showed poorer BP control. Results corroborate a higher prevalence of inadequate BP control in Black and Brown men. Furthermore, this intersectional approach evidenced that the prevalence of inadequate BP control in Black women is higher than that in White men, when compared to White women. Findings highlight that, for the development of more equitable BP control strategies, one must consider the specificities of socially marginalized intersectional groups, especially Black men and women.
Assuntos
Anti-Hipertensivos , Hipertensão , Humanos , Feminino , Hipertensão/tratamento farmacológico , Hipertensão/etnologia , Hipertensão/epidemiologia , Masculino , Brasil/epidemiologia , Pessoa de Meia-Idade , Estudos Transversais , Adulto , Idoso , Anti-Hipertensivos/uso terapêutico , Fatores Sexuais , Estudos Longitudinais , Prevalência , População Branca/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/etnologia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Fatores Socioeconômicos , Grupos Raciais/estatística & dados numéricosRESUMO
Farmers' markets are important spaces for the commercialization of fruits and vegetables, which access by the urban population is considered one of the key aspects of healthy cities. This study adopts an ecological approach with geographic-spatial emphasis to describe accessibility to farmers' markets in Porto Alegre-RS, by four different modes of transport (walking, bicycle, bus, and car) and their associations with income and race/skin color. The distribution of markets across the city is more balanced than other food establishments, although physical accessibility is highly uneven across modes of transport: the ability to reach a market on foot in 10 minutes or less is restricted to no more than 25% of the population, while almost 90% can do it by driving a car. The study found a direct and positive association between levels of accessibility to farmers' markets and income: wealthier areas can reach fairs in less time using any mode of transport than poorer ones (p<0.001). Regions with a majority of white inhabitants have better accessibility to the fairs on foot, by bicycle, and by bus (p<0.01) than regions with a majority of Black, Indigenous, or yellow populations.
Assuntos
Renda , Meios de Transporte , Brasil , Humanos , Meios de Transporte/estatística & dados numéricos , Renda/estatística & dados numéricos , Fatores Socioeconômicos , Verduras/provisão & distribuição , Frutas/provisão & distribuição , Etnicidade/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Ciclismo/estatística & dados numéricos , Grupos Raciais/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Comércio/estatística & dados numéricosRESUMO
In recent years, Brazil's non-White (Brown and Black) population became a numerical majority for the first time since the 19th century. Although we know this change was mostly due to racial reclassification, we do not know how such changes are related to skin color, the primary marker of race in Brazil. Using data from six Latin American Public Opinion Project (LAPOP), or America's Barometer, surveys from 2010 to 2023, we examine how changes in racial self-identification (White, Brown, or Black) are related to respondent skin color (light, medium, or dark). We ask how the association between self-identified race and skin color changed over the 13-y period and to what extent these trends varied by educational level. We found a "darkening" of racial identification over time, especially among those with medium and dark skin, who increasingly identified as Black. Brazilians with light skin increasingly identified as Brown, but this was partly explained by changes in interviewer reporting of skin color in the same period. We found only minor evidence that education level was related to changing racial classification over time. Our findings further understanding of recent trends in racial reclassification, which may reflect growing Black consciousness and the extension of racial quotas to both Brown and Black Brazilians in federal universities and public sector jobs.
Assuntos
Pigmentação da Pele , Brasil , Humanos , Masculino , Feminino , Grupos Raciais , AdultoRESUMO
Food insecurity violates the right to regular access to quality food, affecting population groups unequally. In Brazil, FI is associated with both malnutrition and increased obesity and is intertwined with racial and gender inequalities, perpetuating cycles of poverty and social exclusion. This protocol aims to select observational studies that evaluate the association between food insecurity and overweight and their intersectional discussions (gender and race/color). The PRISMA checklist guidelines will be applied, and the PROSPERO platform will be used for registration. Searched in the Virtual Health Library (Lilacs-BVS), Medline PubMed, Web of Science, and Embase Elsevier databases. The stages of article selection and information extraction will be carried out by independent researchers who will identify articles that meet the established inclusion criteria, removing duplicate publications and excluding those that do not meet the requirements. The quality of eligible articles will be assessed using the Quality Assessment Tool For Quantitative Studies (QATFQS), which is recommended for observational studies. This study is not needed for ethical approval, as it is a systematic review based on secondary data. They will disseminate their conclusions from the original articles. PROSPERO registration number: CRD42023427239.
Assuntos
Insegurança Alimentar , Sobrepeso , Revisões Sistemáticas como Assunto , Humanos , Sobrepeso/epidemiologia , Feminino , Masculino , Brasil/epidemiologia , Fatores Sexuais , Grupos RaciaisRESUMO
Human cerumen analysis is an innovative and non-invasive trend in diagnosing diseases. Recently, new cerumen volatile-based methods using binary (volatile presence/absence) and semiquantitative (volatile intensity) data approaches have shown great potential in detecting biomarkers for cancer, chronic and rare diseases, and xenobiotic exposures. However, to date, the impacts of demographic factors such as body mass index (BMI), sex, age, and ethnicity/race in cerumen data have not been widely described, which can hamper interpretation in biomarker discovery investigations. This study examined the effects of such factors in cerumen, defining the baseline volatile organic metabolites (VOMs) across different physiological groups. Cerumen samples from seventy volunteers were analyzed using headspace/gas chromatography-mass spectrometry (HS/GC-MS) and multivariate statistical analysis using binary and semiquantitative data approaches. In the binary data approach, several VOMs exhibited patterns of high occurrence in some specific demographic groups. However, no pattern of discrimination that could be attributed to demographic factors was observed. In the semiquantitative approach, the relative abundance of cerumen VOMs was more impacted by sex and BMI than age and ethnicity/race. In summary, we describe how cerumen VOM occurrence and abundance are affected by patient phenotype, which can pave the way for more personalized medicine in future cerumen volatile-based methods.
Assuntos
Índice de Massa Corporal , Cerume , Etnicidade , Cromatografia Gasosa-Espectrometria de Massas , Compostos Orgânicos Voláteis , Humanos , Masculino , Compostos Orgânicos Voláteis/análise , Feminino , Adulto , Cerume/metabolismo , Pessoa de Meia-Idade , Fatores Etários , Fatores Sexuais , Análise de Dados , Idoso , Adulto Jovem , Biomarcadores , Grupos RaciaisRESUMO
COVID-19 and obesity are two concurrent, interrelated pandemics that share similarities in their social causes, including racism. It is essential to understand how their characteristics are interrelated and the possible role of obesity in the association between race and COVID-19 mortality. We investigated the relationship between race and COVID-19 mortality and the modifying effect of obesity on this relationship. It is a retrospective cohort study. We analyzed data from 113,737 adults aged ≥ 19 years hospitalized for COVID-19 in Rio Grande do Sul, Brazil. The study outcome was in-hospital COVID-19 mortality. Exposures included race, analyzed as white, Brown, and Black individuals and as white vs. Brown and Black individuals, and obesity. The cumulative incidence of COVID-19 mortality was 33.46% (95% CI 33.18-33.74). Compared with white individuals, Brown individuals had a 39% higher likelihood of death from COVID-19 (95% CI 1.28-1.52), while Black individuals had a 30% higher likelihood (95% CI 1.20-1.41). Brown women with obesity had the greatest likelihood of COVID-19 mortality (1.64 [95% CI 1.27-2.13]) compared with all other groups. Obesity was an effect modifier of the association between race and COVID-19 mortality, increasing the likelihood of mortality in the group of Brown women.
Assuntos
COVID-19 , Obesidade , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Brasil/epidemiologia , COVID-19/mortalidade , COVID-19/epidemiologia , Obesidade/mortalidade , Obesidade/epidemiologia , Estudos Retrospectivos , População Branca/estatística & dados numéricos , Grupos Raciais/estatística & dados numéricos , Etnicidade/estatística & dados numéricosRESUMO
The way that societies assign people to racial categories has far-reaching social, economic, and political consequences. One framework for establishing racial boundaries is based on ancestry, which historically has been leveraged to create rigid racial categories, particularly with respect to being categorized as White. A second framework is based on skin tone, which can vary within families and across the lifespan, and is thus more likely to blur racial boundaries. The persistence of these distinct cultural beliefs about race requires that they be transmitted to each new generation, but there have been few cross-cultural studies on their development during childhood. Participants (5- to 12-year-old children, N = 123) were from the United States, in which the ancestry model has been more prevalent, or from Brazil, in which the skin tone model has been more prevalent. In both countries, 5- to 7-year-olds endorsed the belief that skin tone determines race, for example, by assigning biological siblings with differing skin tones to different racial categories. However, racial concepts diverged among the 10- to 12-year-olds, with children from the United States shifting toward a classification based on ancestry and children in Brazil endorsing a classification based on skin tone even more strongly with age. These differing conceptions were especially evident with reference to White racial categorization: Older children from Brazil persisted in classifying lighter skinned people as White when they had African ancestry, unlike older children from the United States. These findings provide important insights into the developmental and cultural influences on racial classification systems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Assuntos
Desenvolvimento Infantil , Grupos Raciais , Humanos , Criança , Masculino , Feminino , Pré-Escolar , Estados Unidos , Desenvolvimento Infantil/fisiologia , Brasil , Comparação Transcultural , Pigmentação da PeleRESUMO
OBJECTIVE: To investigate inequalities related to race/ethnicity and socioeconomic status in self-reported positive diagnosis for COVID-19 in Brazilian adults. METHODS: Data available from the National Household Sample Survey COVID-19 (PNAD COVID 19) (July/September/November, 2020) were used in this retrospective investigation. The analyses considered the sampling design, primary sampling units, strata and sample weights. Poisson regression with robust variance was used to estimate prevalence ratio (PR) and the 95% confidence interval (95%CI) of the associations. RESULTS: In July, September and November 2020, with regard to the rapid test, indigenous people were 2.45 (95%CI 1.48-4.08), 2.53 (95%CI 1.74-4.41) and 1.23 (95%CI 1.11-1.86) times more likely to report a positive history of SARS-CoV-2 infection, respectively. With regard to the RT-PCR test in November, indigenous people were more likely to test positive for COVID-19 (PR: 1.90; 95%CI 1.07-3.38). It was observed that the indigenous group was 1.86 (95%CI 1.05-3.29) and 2.11 (95%CI 1.12-3.59) times more likely to test positive for COVID-19 in September and November (2020). Income was associated with testing positive for COVID-19: in November, individuals whose income ranged from R$0.00-R$1.044 were more likely (PR: 1.69; 95%CI 1.16-23.06) to test positive using the RT-PCR test; participants whose income was in this range were also more likely to be diagnosed with COVID-19 using blood tests (PR: 1.72; 95%CI 1.43-2.07). CONCLUSION: The data presented show an association between race/ethnicity and economic status with a positive diagnosis of COVID-19.
Assuntos
COVID-19 , Etnicidade , Grupos Raciais , Fatores Socioeconômicos , Humanos , Brasil/epidemiologia , COVID-19/epidemiologia , Povos Indígenas/estatística & dados numéricos , Estudos Retrospectivos , Etnicidade/estatística & dados numéricos , Grupos Raciais/estatística & dados numéricos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-IdadeAssuntos
Equidade de Gênero , Feminino , Humanos , Masculino , Diversidade Cultural , Grupos RaciaisRESUMO
OBJECTIVE: To analyze the incompleteness and trend of incompleteness of the race/color variable in hospitalizations due to COVID-19 whose outcome was death, in Brazil, between April 2020 and April 2022. METHODS: Ecological time series study on the incompleteness of the race/color variable in hospitalizations due to COVID-19 whose outcome was death in Brazil, its macro-regions and Federative Units (FU), by joinpoint regression, calculation of Monthly Percent Change (MPC) and Average Monthly Percent Change (AMPC), based on data from the Hospital Information System of the Unified Health System (SIH/SUS). RESULTS: The incompleteness of the race/color variable in COVID-19 hospitalizations with a death outcome in Brazil was 25.85%, considered poor. All regions of the country had a poor degree of incompleteness, except for the South, which was considered regular. In the period analyzed, the joinpoint analysis revealed a stable trend in the incompleteness of the race/color variable in Brazil (AMPC = 0.54; 95%CI: -0.64 to 1.74; p = 0.37) and in the Southeast (AMPC = -0.61; 95%CI: -3.36 to 2.22; p = 0.67) and North (AMPC = 3.74; 95%CI: -0.14 to 7.78; p = 0.06) regions. The South (AMPC = 5.49; 95%CI: 2.94 to 8.11; p = 0.00002) and Northeast (AMP = 2.50; 95%CI: 0.77 to 4.25; p = 0.005) regions showed an increase in the incompleteness trend, while the Midwest (AMPC = -2.91 ; 95%CI: -5.26 to -0.51; p = 0.02) showed a downward trend. CONCLUSION: The proportion of poor completeness and the stable trend of incompleteness show that there was no improvement in the quality of filling in the race/color variable during the COVID-19 pandemic in Brazil, a fact that may have increased health inequalities for the black population and made it difficult to plan strategic actions for this population, considering the pandemic context. The results found reinforce the need to encourage discussion on the subject, given that the incompleteness of health information systems increases inequalities in access to health services and compromises the quality of health data.
Assuntos
COVID-19 , Disparidades em Assistência à Saúde , Hospitalização , Humanos , Brasil/epidemiologia , COVID-19/mortalidade , Disparidades em Assistência à Saúde/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Pandemias , Grupos Raciais/estatística & dados numéricos , Fatores SocioeconômicosRESUMO
Neste artigo, analisamos o documentário Endometriose: uma vida moldada pela dor, material que tem como objetivo "mostrar, tirar da invisibilidade e dar voz" a mulheres que vivem com intensa dor crônica causada pela doença que dá título à obra. Discutiremos, preliminarmente, as dificuldades e potencialidades do testemunho da dor física, a partir de reflexões de Scarry, Sontag e Bourke. Em seguida, abordaremos três fatores de caráter histórico-social que podem ajudar a explicar o silenciamento da experiência das pacientes: os limites da compaixão médica, especialmente relacionados a questões de gênero, classe e raça; a construção da ideia do corpo feminino como inerentemente patológico e as complexidades na relação médico-paciente em sua interseção com o gênero. Por fim, no último tópico do trabalho, trataremos dos esforços das mulheres com endometriose no sentido de tornar sua dor inteligível e modular que resposta desejam receber de seus interlocutores.
In this essay, we analyze the documentary Endometriosis: a life shaped by pain, a material that aims to "show, remove from invisibility and give voice" to women who live with intense chronic pain caused by endometriosis. We will preliminarily discuss the difficulties and potentialities of witnessing physical pain, based on the work of Scarry, Sontag and Bourke. Next, we will address three socio-historical factors that can help explain the silencing of patients' experiences: first, the limits of medical compassion, especially related to issues of gender, class and race; second, the construction of the idea of the female body as inherently pathological; third, the complexities in the doctor-patient relationship as it intersects with gender. Finally, in the last topic of the work, we will examine the efforts of endometriosis patients to make their pain intelligible and modulate the response they want to receive from their interlocutors.
En este artículo analizamos el documental Endometriosis: una vida marcada por el dolor, material que pretende "mostrar, sacar de la invisibilidad y dar voz" a mujeres que viven con intensos dolores crónicos provocados por la endometriosis. Discutiremos preliminarmente las dificultades y potencialidades de presenciar el dolor físico, a partir del pensamiento de Scarry, Sontag y Bourke. A continuación, abordaremos tres factores histórico-sociales que pueden ayudar a explicar el silenciamiento de las experiencias de los pacientes: primero, los límites de la compasión médica, especialmente relacionados con cuestiones de género, clase y raza; segundo, la construcción de la idea del cuerpo femenino como inherentemente patológico; tercero, las complejidades de la relación médico-paciente en su intersección con el género. Finalmente, en el último tema del trabajo, discutiremos los esfuerzos de las pacientes con endometriosis por hacer inteligible su dolor y modular la respuesta que quieren recibir de sus interlocutores.
Assuntos
Dor , Condições Sociais , Serviços de Saúde da Mulher , Saúde da Mulher , Comunicação , Assistência Integral à Saúde , Política de Saúde , Classe Social , Grupos Raciais , Dismenorreia , Endometriose , Dor Aguda , Fadiga de CompaixãoRESUMO
In Brazil, ethnic-racial inequalities exist in all fields, obstructing access to goods, services, and opportunities, including healthcare services. However, there are no apparent studies that assess, at a national level, ethnic-racial disparities in poisoning cases, emphasizing skin color as a determining factor. The study aimed to examine the relationship between race/ethnicity and general poisoning cases, by medications, pesticides, and drug of abuse in Brazilian states. Poisoning cases data were extracted for the years 2017, 2018, and 2019. Notification data for general poisoning cases and toxic agents were collected: medications, pesticides, and drugs of abuse. Data were categorized between whites and non-whites (blacks, browns, and indigenous) and without information on skin color/ethnicity. Rates of poisonings amongst ethnic-racial groups and cases of not declared skin color as well as relative risk (RR) of poisoning among non-whites were calculated. All states in the North, Northeast (states with the worst Human Development Index), Midwest, and 2 states in the Southeast exhibited higher rates of poisoning cases per 100,000 inhabitants among non-whites. The RR values for nonwhite individuals were higher in the North and Northeast regions for all types of poisonings. The type of poisoning cases that presented the highest RR for non-whites over the 3 years was drugs of abuse (2-2.44), when compared to other types of poisonings from pesticides (2-2.33) and medications (1.5-1.91). The spatial distribution of poisoning cases rates and RR of nonwhite population support public policies to reduce socioeconomic and environmental inequalities.
Assuntos
Praguicidas , Intoxicação , Brasil/epidemiologia , Humanos , Praguicidas/intoxicação , Intoxicação/epidemiologia , Adulto , Adulto Jovem , Adolescente , Feminino , Masculino , Pessoa de Meia-Idade , Criança , Etnicidade/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Pré-Escolar , Grupos Raciais/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Preparações FarmacêuticasRESUMO
We conducted a cross-sectional study of hypertension care in public and private services, analyzing gender, color, and socioeconomic status. Using data from the 2013 (n = 60,202) and 2019 (n = 90,846) national health surveys, hypertension prevalence increased from 21.4 to 23.9%. Quality of care declined from 41.7 to 35.4%, particularly in public services, disproportionately affecting low-income Black women. Poisson regression estimated prevalence ratios (PRs), with the lowest adjusted PR for high-quality care among low-income Black women. These findings highlight persistent health inequalities and the urgent need for intersectoral policies to promote health equity.
Assuntos
Hipertensão , Qualidade da Assistência à Saúde , Humanos , Brasil , Hipertensão/terapia , Hipertensão/etnologia , Hipertensão/epidemiologia , Feminino , Estudos Transversais , Masculino , Pessoa de Meia-Idade , Adulto , Qualidade da Assistência à Saúde/estatística & dados numéricos , Fatores Socioeconômicos , Fatores Sexuais , Inquéritos Epidemiológicos , Setor Privado , Disparidades em Assistência à Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Idoso , Setor Público , Grupos Raciais/estatística & dados numéricos , Prevalência , Adulto Jovem , AdolescenteRESUMO
BACKGROUND: Outcomes in alcohol-associated liver disease (ALD) are influenced by several race and ethnic factors, yet its natural history across the continuum of patients in different stages of the disease is unknown. METHODS: We conducted a retrospective cohort study of U.S. adults from 2011 to 2018, using three nationally representative databases to examine potential disparities in relevant outcomes among racial and ethnic groups. Our analysis included logistic and linear regressions, along with competing risk analysis. RESULTS: Black individuals had the highest daily alcohol consumption (12.6 g/day) while Hispanic participants had the largest prevalence of heavy episodic drinking (33.5%). In a multivariable-adjusted model, Hispanic and Asian participants were independently associated with a higher ALD prevalence compared to Non-Hispanic White interviewees (OR: 1.4, 95% CI: 1.1-1.8 and OR: 1.5 95% CI:1.1-2.0, respectively), while Blacks participants had a lower ALD prevalence (OR: .7 95% CI: .6-.9), and a lower risk of mortality during hospitalization due to ALD (OR: .83 95% CI: .73-.94). Finally, a multivariate competing-risk analysis showed that Hispanic ethnicity had a decreased probability of liver transplantation if waitlisted for ALD (SHR: .7, 95% CI: .6-.8) along with female Asian population (HR: .40, 95% CI: .26-.62). CONCLUSIONS: After accounting for key social and biological health determinants, the Hispanic population showed an increased risk of ALD prevalence, even with lower alcohol consumption. Additionally, Hispanic and Asian female patients had reduced access to liver transplantation compared to other enlisted patients.
Assuntos
Hepatopatias Alcoólicas , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Etnicidade/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Hepatopatias Alcoólicas/etnologia , Modelos Logísticos , Prevalência , Estudos Retrospectivos , Fatores de Risco , Estados Unidos/epidemiologia , Grupos Raciais/estatística & dados numéricosRESUMO
Contexto - A Política Nacional de Saúde Integral da População Negra (PNSIPN) foi instituída em 2009, com o objetivo de "promover a saúde integral da população negra, priorizando a redução das desigualdades étnico-raciais, o combate ao racismo e à discriminação nas instituições e nos serviços do SUS". Entre as pessoas em vulnerabilidade por questões étnico-raciais, a população negra e a indígena estão entre as que sofrem com diversas iniquidades em saúde ocasionadas por barreiras estruturais e cotidianas que incidem negativamente nos indicadores de saúde. Diante do panorama iniciado pela PNSIPN, foram estabelecidos indicadores para o monitoramento da implementação e o desenvolvimento do Guia de Implementação do Quesito Raça/Cor/Etnia. Pergunta - Qual é o grau de qualidade do preenchimento do quesito raça/cor nos sistemas de registro de dados administrativos da saúde? Métodos - As buscas foram realizadas em julho de 2024 nas bases de dados BVS - Biblioteca Virtual em Saúde e Google Acadêmico. Foram utilizados os filtros temporais (2019 a 2024). O processo de seleção de estudos recuperados foi realizado em duplicidade e de modo independente. Resultados - De 1.340 registros recuperados nas buscas, 27 estudos foram incluídos. Os resultados são apresentados de acordo com os sistemas de informação analisados.
Context - The National Policy for Comprehensive Health of the Black Population (PNSIPN) was established in 2009, with the objective of "promoting the comprehensive health of the black population, prioritizing the reduction of ethnic-racial inequalities, combating racism and discrimination in SUS institutions and services". Among people vulnerable due to ethnic-racial issues, the black and indigenous populations are among those who suffer from various health inequities caused by structural and daily barriers that negatively impact health indicators. Given the panorama initiated by the PNSIPN, indicators were established to monitor the implementation and develop the Implementation Guide for the Race/Color/Ethnicity Question. Question - What is the degree of quality of filling out the race/color question in the administrative health data registration systems? Methods - The searches were carried out in July 2024 in the BVS - Virtual Health Library and Google Scholar databases. Time filters were used (2019 to 2024). The selection process of retrieved studies was carried out in duplicate and independently. Results - Of 1,340 records retrieved in the searches, 27 studies were included. The results are presented according to the information systems analyzed.
Assuntos
Grupos Raciais , Sistemas de Informação , Revisão , População NegraRESUMO
BACKGROUND: Race and ethnicity are important drivers of health inequalities worldwide. However, the recording of race/ethnicity in data systems is frequently insufficient, particularly in low- and middle-income countries. The aim of this study is to descriptively analyse trends in data completeness in race/color records in hospital admissions and the rates of hospitalizations by various causes for Blacks and Whites individuals. METHODS: We conducted a longitudinal analysis, examining hospital admission data from Brazil's Hospital Information System (SIH) between 2010 and 2022, and analysed trends in reporting completeness and racial inequalities. These hospitalization records were examined based on year, quarter, cause of admission (using International Classification of Diseases (ICD-10) codes), and race/color (categorized as Black, White, or missing). We examined the patterns in hospitalization rates and the prevalence of missing data over a period of time. RESULTS: Over the study period, there was a notable improvement in data completeness regarding race/color in hospital admissions in Brazil. The proportion of missing values on race decreased from 34.7% in 2010 to 21.2% in 2020. As data completeness improved, racial inequalities in hospitalization rates became more evident - across several causes, including assaults, tuberculosis, hypertensive diseases, at-risk hospitalizations during pregnancy and motorcycle accidents. CONCLUSIONS: The study highlights the critical role of data quality in identifying and addressing racial health inequalities. Improved data completeness has revealed previously hidden inequalities in health records, emphasizing the need for comprehensive data collection to inform equitable health policies and interventions. Policymakers working in areas where socioeconomic data reporting (including on race and ethnicity) is suboptimal, should address data completeness to fully understand the scale of health inequalities.
Assuntos
Sistemas de Informação em Saúde , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Sistemas de Informação Hospitalar , Feminino , Humanos , Masculino , Brasil , Sistemas de Informação em Saúde/normas , Disparidades em Assistência à Saúde/estatística & dados numéricos , Sistemas de Informação Hospitalar/normas , Hospitalização/estatística & dados numéricos , Estudos Longitudinais , Grupos Raciais/estatística & dados numéricos , Fatores Socioeconômicos , População Branca/estatística & dados numéricos , População Negra/estatística & dados numéricosRESUMO
Epidemiological studies frequently classify groups based on phenotypes like self-reported skin color/race, which inaccurately represent genetic ancestry and may lead to misclassification, particularly among individuals of multiracial backgrounds. This study aimed to characterize both global and local genome-wide genetic ancestries and to assess their relationship with self-reported skin color/race in an admixed population of Sao Paulo city. We analyzed 226,346 single-nucleotide polymorphisms from 841 individuals participating in the population-based ISA-Nutrition study. Our findings confirmed the admixed nature of the population, demonstrating substantial European, significant Sub-Saharan African, and minor Native American ancestries, irrespective of skin color. A correlation was observed between global genetic ancestry and self-reported color-race, which was more evident in the extreme proportions of African and European ancestries. Individuals with higher African ancestry tended to identify as Black, those with higher European ancestry tended to identify as White, and individuals with higher Native American ancestry were more likely to self-identify as Mixed, a group with diverse ancestral compositions. However, at the individual level, this correlation was notably weak, and no deviations were observed for specific regions throughout the individual's genome. Our findings emphasize the significance of accurately defining and thoroughly analyzing race and ancestry, especially within admixed populations.
Assuntos
Polimorfismo de Nucleotídeo Único , Autorrelato , Pigmentação da Pele , Humanos , Brasil , Pigmentação da Pele/genética , Masculino , Feminino , Adulto , População Branca/genética , População Urbana , População Negra/genética , Grupos Raciais/genética , Pessoa de Meia-Idade , Genética PopulacionalRESUMO
BACKGROUND: The occurrence of multimorbidity and its impacts have differentially affected population subgroups. Evidence on its incidence has mainly come from high-income regions, with limited exploration of racial disparities. This study investigated the association between racial groups and the development of multimorbidity and chronic conditions in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: Data from self-reported white, brown (pardos or mixed-race), and black participants at baseline of ELSA-Brasil (2008-2010) who were at risk for multimorbidity were analysed. The development of chronic conditions was assessed through in-person visits and self-reported diagnosis via telephone until the third follow-up visit (2017-2019). Multimorbidity was defined when, at the follow-up visit, the participant had two or more morbidities. Cumulative incidences, incidence rates, and adjusted incidence rate ratios (IRRs) were estimated using Poisson models. RESULTS: Over an 8.3-year follow-up, compared to white participants: browns had a 27% greater incidence of hypertension and obesity; and blacks had a 62% and 45% greater incidence, respectively. Blacks also had 58% more diabetes. The cancer incidence was greater among whites. Multimorbidity affected 41% of the participants, with a crude incidence rate of 57.5 cases per 1000 person-years (ranging from 56.3 for whites to 63.9 for blacks). Adjusted estimates showed a 20% higher incidence of multimorbidity in black participants compared to white participants (IRR: 1.20; 95% CI: 1.05-1.38). CONCLUSIONS: Significant racial disparities in the risk of chronic conditions and multimorbidity were observed. Many associations revealed a gradient increase in illness risk according to darker skin tones. Addressing fundamental causes such as racism and racial discrimination, alongside considering social determinants of health, is vital for comprehensive multimorbidity care. Intersectoral, equitable policies are essential for ensuring health rights for historically marginalized groups.
Assuntos
Multimorbidade , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Brasil/epidemiologia , Doença Crônica , Disparidades nos Níveis de Saúde , Incidência , Estudos Longitudinais , Estudos Prospectivos , Fatores Socioeconômicos , População Branca/estatística & dados numéricos , População Negra , Grupos RaciaisRESUMO
Introduction: In areas with limited access to healthcare systems, Resting Energy Expenditure (REE) estimation is performed using predictive equations to calculate an individual's caloric requirement. One problem is that these equations were validated in populations with different characteristics from those in Latin America, such as race, height, or body mass, leading to potential errors in the prediction of this parameter. Objective: To determine the REE using predictive formulas compared with bioimpedance in Peruvians. Materials and methods: A comparative analytical cross-sectional study with secondary database analysis of the CRONICAS cohort. Results: we worked with a total of 666 subjects. The Mjeor equation was the one with the highest rating of 0.95, a lower mean absolute percentage error (MAPE) of 4.69%, and equivalence was found with the REE values. In the multiple regression, it was observed that the Mjeor equation was the one that least overestimated the REE, increasing 0.77 Kcal/day (95% CI: 0.769-0.814; p<0.001) for each point that increased the REE determined by bioimpedance. The strength of association between Mjeor and bioimpedance was 0.9037. Furthermore, in the regression of the data (weight, height, age) in the Mjeor equation it was observed that the coefficients obtained were the same as those used in the original equation. Conclusions: The Mjeor equation seems to be the most adequate to estimate the REE in the Peruvian population. Future prospective studies should confirm the usefulness of this formula with potential utility in primary health care(AU)
Introducción: En zonas con acceso limitado a sistemas de salud, la estimación del Gasto Energético en Reposo (GER) se realiza utilizando ecuaciones predictivas para calcular el requerimiento calórico de un individuo. Uno de los problemas es que estas ecuaciones fueron validadas en poblaciones con características diferentes a las latinoamericanas, como raza, talla o masa corporal, lo que conlleva a potenciales errores en la predicción de este parámetro. Objetivo: Determinar el GER mediante fórmulas predictivas comparadas con la bioimpedancia en peruanos. Materiales y métodos: Estudio transversal analítico comparativo con análisis secundario de base de datos de la cohorte CRONICAS. Resultados: Se trabajó con un total de 666 sujetos. La ecuación de Mjeor fue la que obtuvo la puntuación más alta de 0,95, un error medio porcentual absoluto (MAPE) inferior de 4,69%, y se encontró equivalencia con los valores del GER. En la regresión múltiple, se observó que la ecuación de Mjeor fue la que menos sobreestimó el GER, aumentando 0,77 Kcal/día (IC 95%: 0,769-0,814; p<0,001) por cada punto que aumentaba el GER determinado por bioimpedancia. La fuerza de asociación entre Mjeor y bioimpedancia fue de 0,9037. Además, en la regresión de los datos (peso, talla, edad) de la ecuación de Mjeor se observó que los coeficientes obtenidos eran los mismos que los utilizados en la ecuación original. Conclusiones: La ecuación de Mjeor parece ser la más adecuada para estimar el GER en la población peruana. Futuros estudios prospectivos deberán confirmar la utilidad de esta fórmula para su potencial utilidad en la atención primaria de salud(AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Impedância Elétrica , Metabolismo Energético , Previsões , Índice de Massa Corporal , Grupos Raciais , Dieta , ObesidadeRESUMO
OBJECTIVE: This study aimed to compare the nasopharynx and oropharynx airway dimensions of Caucasians, Blacks, Japanese, Japanese Brazilians, and Black Caucasians. METHODS: A sample of 216 lateral radiographs of untreated young Brazilian subjects (mean age of 12.94 years; SD 0.88) were divided into five groups: Black Caucasian, Black, Caucasian, Japanese, and Japanese Brazilian. Lateral radiographs were used to measure the oropharynx (from the midpoint on the soft palate to the closest point on the anterior pharyngeal wall) and the nasopharynx (from the intersection of the posterior border of the tongue and the inferior border of the mandible to the closest point on the posterior pharyngeal wall). Analyses of variance (ANOVA) and Tukey's test were performed (p< 0.05). RESULTS: The linear dimension of the oropharynx was similar among the different ethnic groups. Caucasian individuals presented a significantly greater linear dimension of the nasopharynx than Black Caucasian and Black individuals. CONCLUSIONS: All the groups had similar buccopharyngeal values. However, Caucasian individuals had significantly higher values when compared to Black Caucasians and Black individuals.