Raça, cor e etnia em estudos epidemiológicos sobre populações brasileiras: revisão sistemática na base PubMed

Physis Revista de Saúde Coletiva 07/2012; 22(3):895-918. DOI: 10.1590/S0103-7331201200030000


This paper aims to analyze the use of the variables race, color and ethnicity in epidemiologic studies, carried out with Brazilian populations. This is a systematic review, conducted in the PubMed bibliographic database, on papers published between January 2000 and July 2010. A data extraction form was used to obtain data from all individual studies, such as their objectives, the relevance of the racial/ethnic classification in their analyses, participants' socio-demographic characteristics, including aspects related to the methods of racial classification, as well as the adherence to a set of recommendations on the use of race, color and ethnicity in biomedical publications. After initially identifying 1,174 references, 151 were included in the review. Higher proportions of each of the following results were observed among papers in which the racial/ethnic classification was central to their analyses - of these, 18% justified the use of racial/ethnic categories; 16% regarded racial/ethnic classifications as context-dependent and fluid; 65% described the methods adopted for racial/ethnic classification; 17% took the racial/ethnic classification as a proxy for genetic variation; 26% considered such classification as a risk factor for health outcomes; 47% considered socio-economic factors in the interpretation of racial/ethnic inequalities in health; and 27% adjusted these racial/ethnic disparities for socio-economic factors in their statistical models. Only two studies elucidated the concept underlying the use of race, color or ethnicity. An expressive amount of the reviewed epidemiologic studies does not follow minimum established criteria on the use of variables regarding racial/ethnic classification, such that this should be urgently improved in public health research.

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    ABSTRACT: 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.
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    ABSTRACT: Objective: To describe the victimization and bullying practice in Brazilian school children, according to data from the National Adolescent School-based Health Survey and to compare the surveys from 2009 and 2012. Methods: This is a cross-sectional study with univariate and multivariate analyzes of the following variables: to have been treated badly by colleagues, to have been bullied and to have bullied other children. The following independent variables were analyzed: age, sex, race/color, type of school, maternal education. Prevalence rates were compared between the editions of 2009 and 2012 of the survey. Results: Of all the adolescents analyzed, 27.5% have not been treated well by peers at school, with greater frequency among boys (OR = 1.50), at the age of 15 years (OR = 1.29) and 16 (OR = 1.41), public school students (OR = 2.08), black (OR = 1.18) and whose mothers had less education; 7.2% reported having been bullied, with a greater chance in younger students (13 years old), male (OR = 1.26), black (OR = 1.15) and indigenous (OR = 1.16) and whose mothers had less education; 20.8% reported to have bullied other children, with a greater chance for older students, at the age of 14 (OR = 1.08) and 15 years (OR = 1.18), male (OR = 1.87), black (OR = 1.14) and yellow (OR = 1.15), children of mothers with higher education, private school students. There was an increase of bullying in the Brazilian capitals, from 5.4 to 6.8%, between 2009 and 2012. Discussion: The occurrence of bullying reveals that the Brazilian school context is also becoming a space of reproduction of violence, in which it is crucial to act intersectorally and to articulate social protection networks, aiming to face this issue.
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