Racial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA‑Brasil)
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2022 |
| Outros Autores: | , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/54570 |
Resumo: | Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil. |
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Oliveira, Fernanda Esthefane GarridesGriep, Rosane HarterChor, DoraGiatti, LuanaMachado, Luciana A. C.Barreto, Sandhi MariaPereira, Alexandre da CostaFonseca, Maria de Jesus Mendes daBastos, Leonardo Soares2022-08-10T18:23:26Z2022-08-10T18:23:26Z2022OLIVEIRA, Fernanda Esthefane Garrides et al. Racial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA‑Brasil). BMC Public Health, v. 22, 1319, p. 1 - 15, 2022.1471-2458https://www.arca.fiocruz.br/handle/icict/5457010.1186/s12889-022-13715-7engBMCMultimorbidadeDoença crônicaAcúmulo de doençasDesigualdades raciais em saúdeDeterminantes sociais da saúdeMultimorbidityChronic diseaseDisease accumulationRacial inequalities in healthSocial determinants of healthRacial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA‑Brasil)info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Universidade Federal de Minas Gerais. Departamento de Prevenção e Medicina Social. Belo Horizonte, MG, Brasil.Universidade Federal de Minas Gerais. Hospital das Clínicas/EBSERH. Belo Horizonte, MG, Brasil.Universidade Federal de Minas Gerais. Departamento de Prevenção e Medicina Social. Belo Horizonte, MG, Brasil.Universidade de São Paulo. Instituto do Coração. São Paulo, SP, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Programa de Computação Científica. Programa de Computação CientíficaBackground: Evidence of multimorbidity has come mainly from high-income regions, while disparities among racial groups have been less explored. This study examined racial differences in multimorbidity in the multiracial cohort of the Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto), ELSA-Brasil. Methods: The study examined baseline (2008–2010) data for 14 099 ELSA-Brasil participants who self-reported being white, mixed-race, or black. A list of 16 morbidities was used to evaluate multimorbidity, operationalised by simple count into ≥ 2, ≥ 3, ≥ 4, ≥ 5 and ≥ 6 morbidities, in addition to evaluating the number of coexisting conditions. Prevalence ratios (PR) were estimated from logistic models and a quantile model was used to examine racial differences graphically in the distribution quantiles for the number of morbidities. Results: Overall prevalence of multimorbidity (≥ 2 morbidities) was 70% and, after controlling for age and sex, was greater among mixed-race and black participants – by 6% (PR: 1.06; 95% CI: 1.03–1.08) and 9% (PR: 1.09; 95% CI: 1.06–1.12), respectively – than among white participants. As the cutoff value for defining multimorbidity was raised, so the strength of the association increased, especially among blacks: if set at ≥ 6 morbidities, the prevalence was 27% greater for those of mixed-race (PR: 1.27; 95% CI: 1.07–1.50) and 47% greater for blacks (PR: 1.47; 95% CI: 1.22–1.76) than for whites. The disparities were smaller in the lower morbidity distribution quantiles and larger in the upper quantiles, indicating a heavier burden of disease, particularly on blacks. Conclusions: Multimorbidity was common among adults and older adults in a Brazilian cohort, but important racial inequalities were found. Raising the cutoff point for defining multimorbidity revealed stronger associations between race/skin colour and multimorbidity, indicating a higher prevalence of multimorbidity among mixed-race and black individuals than among whites and that the former groups coexisted more often with more complex health situations (with more coexisting morbidities). Interventions to prevent and manage the condition of multimorbidity that consider the social determinants of health and historically discriminated populations in low- and middle-income regions are necessary.info:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/54570/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALRosaneGriep_FernandaOliveira_etal_IOC_2022.pdfRosaneGriep_FernandaOliveira_etal_IOC_2022.pdfapplication/pdf1477645https://www.arca.fiocruz.br/bitstream/icict/54570/2/RosaneGriep_FernandaOliveira_etal_IOC_2022.pdfe8ef0694413ebcece2a17b7ce62ade17MD52icict/545702022-08-10 15:23:26.662oai:www.arca.fiocruz.br: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ório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352022-08-10T18:23:26Repositório Institucional da FIOCRUZ (ARCA) - 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| dc.title.pt_BR.fl_str_mv |
Racial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA‑Brasil) |
| title |
Racial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA‑Brasil) |
| spellingShingle |
Racial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA‑Brasil) Oliveira, Fernanda Esthefane Garrides Multimorbidade Doença crônica Acúmulo de doenças Desigualdades raciais em saúde Determinantes sociais da saúde Multimorbidity Chronic disease Disease accumulation Racial inequalities in health Social determinants of health |
| title_short |
Racial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA‑Brasil) |
| title_full |
Racial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA‑Brasil) |
| title_fullStr |
Racial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA‑Brasil) |
| title_full_unstemmed |
Racial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA‑Brasil) |
| title_sort |
Racial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA‑Brasil) |
| author |
Oliveira, Fernanda Esthefane Garrides |
| author_facet |
Oliveira, Fernanda Esthefane Garrides Griep, Rosane Harter Chor, Dora Giatti, Luana Machado, Luciana A. C. Barreto, Sandhi Maria Pereira, Alexandre da Costa Fonseca, Maria de Jesus Mendes da Bastos, Leonardo Soares |
| author_role |
author |
| author2 |
Griep, Rosane Harter Chor, Dora Giatti, Luana Machado, Luciana A. C. Barreto, Sandhi Maria Pereira, Alexandre da Costa Fonseca, Maria de Jesus Mendes da Bastos, Leonardo Soares |
| author2_role |
author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Oliveira, Fernanda Esthefane Garrides Griep, Rosane Harter Chor, Dora Giatti, Luana Machado, Luciana A. C. Barreto, Sandhi Maria Pereira, Alexandre da Costa Fonseca, Maria de Jesus Mendes da Bastos, Leonardo Soares |
| dc.subject.other.pt_BR.fl_str_mv |
Multimorbidade Doença crônica Acúmulo de doenças Desigualdades raciais em saúde Determinantes sociais da saúde |
| topic |
Multimorbidade Doença crônica Acúmulo de doenças Desigualdades raciais em saúde Determinantes sociais da saúde Multimorbidity Chronic disease Disease accumulation Racial inequalities in health Social determinants of health |
| dc.subject.en.pt_BR.fl_str_mv |
Multimorbidity Chronic disease Disease accumulation Racial inequalities in health Social determinants of health |
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Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil. |
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2022 |
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2022-08-10T18:23:26Z |
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2022-08-10T18:23:26Z |
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2022 |
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OLIVEIRA, Fernanda Esthefane Garrides et al. Racial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA‑Brasil). BMC Public Health, v. 22, 1319, p. 1 - 15, 2022. |
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https://www.arca.fiocruz.br/handle/icict/54570 |
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1471-2458 |
| dc.identifier.doi.none.fl_str_mv |
10.1186/s12889-022-13715-7 |
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OLIVEIRA, Fernanda Esthefane Garrides et al. Racial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA‑Brasil). BMC Public Health, v. 22, 1319, p. 1 - 15, 2022. 1471-2458 10.1186/s12889-022-13715-7 |
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