Chor Dóra, Lima Claudia Risso de Araujo
Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
Cad Saude Publica. 2005 Sep-Oct;21(5):1586-94. doi: 10.1590/s0102-311x2005000500033. Epub 2005 Sep 12.
In Brazil, data on education, the labor market, and the law enforcement and court systems have already documented that racial discrimination is a structural factor underlying economic and social disadvantages experienced by racial/ethnic minorities. However, racial inequalities in health have received little investigation. According to health indicators presented in this paper, race is a strong predictor of variability in mortality. Early mortality is more frequent among indigenous and black Brazilians; mortality rates from stroke and especially maternal mortality rates are exceedingly higher among black women; violence occurs predominantly among young black men. Lifetime socioeconomic differences across successive generations have been identified as the main cause of racial inequality in health. It is also suggested that racial discrimination and its impact on health are at the origin of these inequalities. Instruments to directly or indirectly measure the impact of racial discrimination on health are discussed. The article suggests that investigation of the impact of both social class and race on health is the most productive approach, both for research as well as for policies to address health inequalities.
在巴西，有关教育、劳动力市场以及执法和法院系统的数据已经证明，种族歧视是种族/族裔少数群体在经济和社会方面处于劣势的一个结构性因素。然而，健康方面的种族不平等现象却鲜有研究。根据本文所呈现的健康指标，种族是死亡率差异的一个有力预测因素。巴西原住民和黑人的过早死亡率更高；黑人女性的中风死亡率，尤其是孕产妇死亡率极高；暴力事件主要发生在年轻黑人男性当中。连续几代人一生的社会经济差异已被确认为健康方面种族不平等的主要原因。也有人认为，种族歧视及其对健康的影响是这些不平等现象的根源。本文还讨论了直接或间接衡量种族歧视对健康影响的方法。文章指出，研究社会阶层和种族对健康的影响，无论是对研究还是对解决健康不平等问题的政策而言，都是最有效的途径。
