Mortality by skin color/race, urbanicity, and metropolitan region in Brazil
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This study investigated the mortality rate distribution in Brazilian cities based on skin color/race and according to level of urbanicity and aggregation into metropolitan region (MR) in 2010.
Subjects and methods
The age-adjusted all-cause mortality rate (AMR) was calculated according to skin color/race (white, brown, or black). Municipalities were used as analysis units and classified into six categories: Rural within MR; Rural outside MR; ‘Rurbano’ within MR; ‘Rurbano’ outside MR; Urban within MR and Urban outside MR.
Racial inequality intensified in line with increasing urbanicity level, from rural to urban areas. However, these differences depended on how the city was aggregated to MR, thus suggesting that the mortality spatial structure was based on skin color or race in these locations. The black population presented the worst AMR risk, mainly in cities outside MR. In addition, it was found that there was an excess mortality in the black population as compared with white people.
Mortality-related racial inequalities were associated with urbanicity and MR level. They were also dependent on a complex combination of risk factors in these areas. City categorization may serve as an intervention point to reduce racial inequalities in health among populations in Brazilian cities.
KeywordsMortality Urbanicity Metropolitan area Distribution by race or ethnicity Cities
The authors participated in the design, analysis, and interpretation of the data, writing, and critical review of the article, as well as final approval of the version to be published.
This project was partially funded by the Foundation of Research of Rio de Janeiro (FAPERJ), Brazil [case: E-26/100.357/2013]. The views expressed are those of the authors and not necessarily those of the FAPERJ.
Compliance with ethical standards
This study was elaborated based on aggregated databases on death that are available online. These did not include confidential information regarding personal or home identification. All work was performed in accordance with Resolution No. 466 of the National Health Council [Conselho Nacional de Saúde (CNS)] of 12 December 2012.
Conflict of interest
The authors declare that they have no conflict of interest.
- Bécares L, Shaw R, Nazroo J, Stafford M, Albor C, Atkin K et al (2012) Ethnic density effect on physical morbidity, mortality, and health behaviors: a systematic review of the literature. Am J Public Health 102(12):33–66. https://doi.org/10.2105/AJPH.2012.300832
- Brasil (2014) Ministério da Saúde. Portal da Saúde. Informações de Saúde (TABNET): estatísticas vitais 2014. http://www2.datasus.gov.br/DATASUS/index.php?area=0205&VObj=http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sim/cnv/obt10. Accessed 10 Sept 2015
- Diez-Roux AV (2012) Conceptual approaches to the study of health disparities. Annu Rev Public Health 33:41–58. https://doi.org/10.1146/annurev-publhealth-031811-124534 CrossRefPubMedPubMedCentralGoogle Scholar
- Hinde A (1998) Demographic methods. Arnold, New YorkGoogle Scholar
- IBGE (Instituto Brasileiro de Geografia e Estatística) (2011) Censo demográfico e Contagem da população: população residente, por cor ou raça, segundo a situação do domicílio, o sexo e a idade. Rio de Janeiro; IBGE [quoted 2016 Jun 18]. http://www.sidra.ibge.gov.br/bda/tabela/listabl.asp?c=3175&z=cd&o=7
- Krieger N, Chen JT, Coull BA, Beckfield J, Kiang MV, Waterman PD (2014) Jim Crow and premature mortality among the US Black and White population, 1960–2009: an age–period–cohort analysis. Epidemiology 25(4):494–504. https://doi.org/10.1097/EDE.0000000000000104 CrossRefPubMedPubMedCentralGoogle Scholar
- Laurenti R, Jorge MHPM, Lebrão ML Gotlieb SLD (2005) Estatísticas de Saúde. 2ª ed. EPU, São PauloGoogle Scholar
- Oliveira BLCA Luiz RR (2017) Mortality by skin color/race and urbanity of Brazilian cities. Ethnic Health 22(4):372–388. https://doi.org/10.1080/13557858.2016.1244625
- Szwarcwald CL, Morais-Neto OL, Frias PG, Sousa-Junior PRB, Escalante JJC, Lima RB, Viola RC (2011b) Busca ativa de óbitos e nascimentos no Nordeste e na Amazônia legal: estimação das coberturas do SIM e do SINASC nos municípios brasileiros. In: BRASIL. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Análise de Situação em Saúde. Saúde Brasil 2010: uma análise da situação de saúde e de evidências selecionadas de impacto de ações de vigilância em saúde. Vol 2011. DF, Brasília, pp 79–98 http://bvsms.saude.gov.br/bvs/publicacoes/saude_brasil_2010.pdf
- Telles EE (2004) Race in another America: the significance of skin color in Brazil. Princeton University Press, Princeton and OxfordGoogle Scholar
- Veiga JE (2002) Cidades imaginárias: o Brasil é menos urbano do que se calcula. Autores Associados, CampinasGoogle Scholar
- WHO (2016) World Health Statistics. World Health Organization, Geneva. Instituto Brasileiro de Geografia e Estatística (IBGE) [quoted 2016 out 18] http://gamapserver.who.int/mapLibrary/app/searchResults.aspx