Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.
Bloomberg School of Public Health, John Hopkins University, Baltimore, USA, Bloomberg School of Public Health, John Hopkins University, Baltimore, USA.
Cad Saude Publica. 2014 Feb;30(2):305-17. doi: 10.1590/0102-311X00025413.
We aimed to investigate whether life-course socioeconomic position mediates the association between skin color/race and occurrence of uterine leiomyomas. We analyzed 1,475 female civil servants with baseline data (1999-2001) of the Pró-Saúde Study in Rio de Janeiro State, Brazil. Life-course socioeconomic position was determined by parental education (early life socioeconomic position), participant education (socioeconomic position in early adulthood) and their combination (cumulative socioeconomic position). Gynecological/breast exams and health insurance status were considered markers of access to health care. Hazard ratios (HR) and 95% confidence intervals (95%CI) were estimated using Cox proportional hazards models. Compared with white women, black and parda ("brown") women had higher risk of reporting uterine leiomyomas, respectively HR: 1.6, 95%CI: 1.2-2.1; HR: 1.4, 95%CI: 0.8-2.5. Estimates were virtually identical in models including different variables related to life-course socioeconomic position. This study corroborated previous evidence of higher uterine leiomyomas risk in women with darker skin color, and further suggest that life-course socioeconomic position adversity does not influence this association.
我们旨在探究一生中的社会经济地位是否会影响肤色/种族与子宫肌瘤发病之间的关联。我们分析了巴西里约热内卢州 Pro-Saúde 研究中 1475 名具有基线数据（1999-2001 年）的女性公务员。一生中的社会经济地位由父母的教育程度（早期社会经济地位）、参与者的教育程度（成年早期的社会经济地位）及其组合（累积社会经济地位）决定。妇科/乳房检查和健康保险状况被视为获得医疗保健的标志。使用 Cox 比例风险模型估计风险比（HR）和 95%置信区间（95%CI）。与白人女性相比，黑人女性和“棕色”女性报告患有子宫肌瘤的风险更高，分别为 HR：1.6，95%CI：1.2-2.1；HR：1.4，95%CI：0.8-2.5。在包含与一生中的社会经济地位相关的不同变量的模型中，估计值几乎相同。这项研究证实了先前的证据，即肤色较深的女性患子宫肌瘤的风险更高，并且进一步表明，一生中的社会经济地位逆境并不会影响这种关联。
