Chiavegatto Filho Alexandre Dias Porto, Laurenti Ruy
Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brasil.
Cad Saude Publica. 2013 Aug;29(8):1572-82. doi: 10.1590/0102-311x00139012.
Recent literature reviews have shown that studies analyzing racial/ethnic disparities in Brazil are still scarce. Multilevel approaches are necessary, since race is a socially constructed concept and can vary by area of residence. The analysis included 2,697 individuals from 145 Brazilian municipalities (counties), classified by race (white, black, or mixed). Multilevel models were fitted using Bayesian inference with Markov Chain Monte Carlo methods. After including demographic, socioeconomic, and health access variables, black and mixed-race individuals showed higher odds of negative self-rated health (OR = 1.71; 95%CI: 1.24; 2.37 and OR = 1.37; 95%CI: 1.10; 1.71, respectively). Characteristics of the area of residence did not significantly affect the association between race and self-rated health. Racial/ethnic disparities lost their statistical significance after re-categorization of the dependent variable. The results indicate that racial/ ethnic disparities in health in Brazil may be deeper and more complex than expected.
近期的文献综述表明,分析巴西种族/民族差异的研究仍然很少。由于种族是一个社会建构的概念,并且可能因居住地区而异,因此采用多层次方法很有必要。该分析纳入了来自巴西145个市(县)的2697名个体,按种族(白人、黑人或混血)分类。使用马尔可夫链蒙特卡罗方法的贝叶斯推断来拟合多层次模型。纳入人口统计学、社会经济和健康获取变量后,黑人和混血个体自我评定健康状况为负面的几率更高(OR分别为1.71;95%CI:1.24;2.37和OR = 1.37;95%CI:1.10;1.71)。居住地区的特征并未显著影响种族与自我评定健康之间的关联。在对因变量重新分类后,种族/民族差异失去了统计学意义。结果表明,巴西健康方面的种族/民族差异可能比预期的更深、更复杂。