Departamento de Salud Comunitaria, Universidad Nacional de Lanús, 29 de Septiembre 3901 (1826) Remedios de Escalada, Lanús, Argentina.
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n-Canela, Salvador, BA, 40110-040, Brazil.
J Racial Ethn Health Disparities. 2018 Oct;5(5):1033-1041. doi: 10.1007/s40615-017-0451-0. Epub 2017 Dec 21.
This study investigates the association between personal-level and group-level discrimination and common mental disorders (CMDs) among Afro-Brazilian women, aiming to explore the role of skin color on this association.
This is a cross-sectional study involving 1130 women who were participating in the Social Change, Asthma and Allergy in Latin America (SCAALA) study, whose children were recruited from 24 geographical micro-regions representative of the population without sanitation. Measures of discrimination were defined by: experiences (personal-level) and concern about discrimination (group-level) using the Experiences of Discrimination Scale. Skin color was registered by self-declaration, being classified as white, brown, and black. The association between "self-reported" discrimination and CMDs was evaluated using Poisson regression analysis.
Prevalence of CMDs was high (38.3%), especially in the group exposed to discriminatory experiences and black women. Experiences and concern about discrimination were positive and significantly associated with mental health, before and after adjustment for potential confounders. The effect of discrimination on CMDs was lower among black women, suggesting the development of other strategies to confront racism.
This study emphasizes the use of both personal- and group-level discrimination measures, as well as skin color, for the evaluation of mental disorders in public health research. Further studies of health consequences of discrimination will require investigation of protective factors for mental disorders in the population suffering discrimination and racism.
本研究旨在探讨个人层面和群体层面的歧视与非裔巴西女性常见精神障碍（CMD）之间的关联，并探索肤色在此关联中的作用。
这是一项横断面研究，共纳入了 1130 名参加社会变化、拉丁美洲哮喘和过敏研究（SCAALA）的女性，这些女性的孩子来自 24 个无卫生设施的代表性地理微观区域。歧视的测量指标是通过歧视经历量表（Experiences of Discrimination Scale）来定义的，包括经历（个人层面）和对歧视的关注（群体层面）。肤色由自我报告确定，分为白色、棕色和黑色。采用泊松回归分析评估“自我报告”歧视与 CMD 之间的关联。
CMD 的患病率较高（38.3%），尤其是经历歧视经历和黑色皮肤的女性。在调整了潜在混杂因素后，歧视经历和对歧视的关注与心理健康呈正相关，且具有统计学意义。歧视对 CMD 的影响在黑人女性中较低，这表明需要制定其他策略来应对种族主义。
本研究强调了在公共卫生研究中使用个人层面和群体层面的歧视测量指标以及肤色来评估精神障碍。进一步研究歧视对健康的影响需要调查受歧视和种族主义影响的人群中精神障碍的保护因素。
