Souto Shayze da Rosa, Anderle Paula, Goulart Bárbara Niegia Garcia de
Departamento de Saúde e Comunicação Humana, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul (UFRGS). R. Ramiro Barcelos 2777, Santa Cecília. 90035-003 Porto Alegre RS Brasil.
Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, UFRGS. Porto Alegre RS Brasil.
Cien Saude Colet. 2022 May;27(5):1919-1928. doi: 10.1590/1413-81232022275.09452021. Epub 2021 Jul 4.
This article aims to verify the association between race/skin color and access to post-stroke rehabilitation services. It is a cross-sectional population-based study including 966 post-stroke adults (≥18 years) that responded to the National Health Survey (PNS). The outcome, access to rehabilitation, and exposure (race/skin color) were collected in a self-reported manner. Socio-demographic variables, clinical history, healthcare plan and post-stroke limitation were considered for the adjustment. Poisson regression with robust variance estimation was used to estimate the association in the crude and adjusted analyses. Based on the sample, 51.8% are self-declared black and 61.4% require rehabilitation, with only 20% having access to the rehabilitation service. Difficulty in accessing rehabilitation was reported by 57.5% of other self-declared races, 43% blacks, and 35.4% whites. In the adjusted analysis, 4% of self-declared black (PR 1.04, CI95%1.00-1.08) and 17% of self-declared yellow and indigenous (PR 1.17, IC95%1.13-1.20) have less access to rehabilitation than their white peers. In Brazil, self-declared black and yellow and indigenous people have worst access to post-stroke rehabilitation in comparison with self-declared white people, highlighting racial inequities in rehabilitation in stroke survivors.
本文旨在验证种族/肤色与中风后康复服务可及性之间的关联。这是一项基于人群的横断面研究，纳入了966名回应全国健康调查（PNS）的中风后成年患者（≥18岁）。康复可及性这一结果以及暴露因素（种族/肤色）通过自我报告的方式收集。在分析中考虑了社会人口学变量、临床病史、医疗保健计划和中风后的功能受限情况。采用稳健方差估计的泊松回归来估计粗分析和调整分析中的关联。基于该样本，51.8%的人自称是黑人，61.4%的人需要康复治疗，而只有20%的人能够获得康复服务。在其他自称其他种族的人群中，57.5%的人报告存在康复可及性困难，黑人中有43%，白人中有35.4%。在调整分析中，自称黑人的人群中有4%（PR 1.04，CI95% 1.00 - 1.08）以及自称黄种人和原住民的人群中有17%（PR 1.17，IC95% 1.13 - 1.20）比他们的白人同龄人获得康复服务的机会更少。在巴西，与自称白人的人群相比，自称黑人、黄种人和原住民的人群获得中风后康复服务的情况更差，这凸显了中风幸存者康复方面的种族不平等。
