Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies

Detalhes bibliográficos
Autor(a) principal: Rebouças, Poliana
Data de Publicação: 2022
Outros Autores: Goes, Emanuelle, Pescarini, Julia, Ramos, Dandara, Ichihara, Maria Yury, Sena, Samila, Veiga, Rafael, Rodrigues, Laura C., Barreto, Maurício L., Paixão, Enny S.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/57272
Resumo: Ministério da Ciência, Tecnologia e Inovação (MCTI). Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). Ministério da Saúde (MS); Secretaria de Ciência, Tecnologia, Inovação e Complexo da Saúde (SCTIE); Departamento de Ciência e Tecnologia (Decit). Bill & Melinda Gates Foundation's. Wellcome Trust.
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spelling Rebouças, PolianaGoes, EmanuellePescarini, JuliaRamos, DandaraIchihara, Maria YurySena, SamilaVeiga, RafaelRodrigues, Laura C.Barreto, Maurício L.Paixão, Enny S.2023-03-08T13:29:41Z2023-03-08T13:29:41Z2022REBOUÇAS, Poliana et al. Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies. Lancet Glob Health, v. 10, n. 10, 2022.2214-109Xhttps://www.arca.fiocruz.br/handle/icict/5727210.1016/S2214-109X(22)00333-3Ministério da Ciência, Tecnologia e Inovação (MCTI). Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). Ministério da Saúde (MS); Secretaria de Ciência, Tecnologia, Inovação e Complexo da Saúde (SCTIE); Departamento de Ciência e Tecnologia (Decit). Bill & Melinda Gates Foundation's. Wellcome Trust.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil / Iyaleta Research Association-Research. Science and Humanities, Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil/ Faculty of Epidemiology and Population Health. London School of Hygiene & Tropical Medicine. London, UK.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil / Instituto de Saude Coletiva, Federal University of Bahia, Salvador, Bahia, Brazil / Iyaleta Research Association-Research. Science and Humanities. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil/ Faculty of Epidemiology and Population Health. London School of Hygiene & Tropical Medicine. London, UK.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para a Saúde. Salvador, BA, Brasil/ Faculty of Epidemiology and Population Health. London School of Hygiene & Tropical Medicine. London, UK.Background: Racism is a social determinant of health inequities. In Brazil, racial injustices lead to poor outcomes in maternal and child health for Black and Indigenous populations, including greater risks of pregnancy-related complications; decreased access to antenatal, delivery, and postnatal care; and higher childhood mortality rates. In this study, we aimed to estimate inequalities in childhood mortality rates by maternal race and skin colour in a cohort of more than 19 million newborns in Brazil. Methods:We did a nationwide population-based, retrospective cohort study using linked data on all births and deaths in Brazil between Jan 1, 2012, and Dec 31, 2018. The data consisted of livebirths followed up to age 5 years, death, or Dec 31, 2018. Data for livebirths were extracted from the National Information System for livebirths, SINASC, and for deaths from the Mortality Information System, SIM. The final sample consisted of complete data for all cases regarding maternal race and skin colour, and no inconsistencies were present between date of birth and death after linkage. We fitted Cox proportional hazard regression models to calculate the crude and adjusted hazard ratios (HRs) and 95% CIs for the association between maternal race and skin colour and all-cause and cause-specific younger than age 5 mortality rates, by age subgroups. We calculated the trend of HRs (and 95% CI) by time of observation (calendar year) to indicate trends in inequalities. Findings From the 20 526 714 livebirths registered in SINASC between Jan 1, 2012, and Dec 31, 2018, 238 436 were linked to death records identified from SIM. After linkage, 1 010 871 records were excluded due to missing data on maternal race or skin colour or inconsistent date of death. 19 515 843 livebirths were classified by mother's race, of which 224 213 died. Compared with children of White mothers, mortality risk for children younger than age 5 years was higher among children of Indigenous (HR 1·98 [95% CI 1·92–2·06]), Black (HR 1·39 [1·36–1·41]), and Brown or Mixed race (HR 1·19 [1·18–1·20]) mothers. The highest hazard ratios were observed during the post-neonatal period (Indigenous, HR 2·78 [95% CI 2·64–2·95], Black, HR 1·54 [1·48–1·59]), and Brown or Mixed race, HR 1·25 [1·23–1·27]) and between the ages of 1 year and 4 years (Indigenous, HR 3·82 [95% CI 3·52–4·15]), Black, HR 1·51 [1·42–1·60], and Brown or Mixed race, HR 1·30 [1·26–1·35]). Children of Indigenous (HR 16·39 [95% CI 12·88–20·85]), Black (HR 2·34 [1·78–3·06]), and Brown or Mixed race mothers (HR 2·05 [1·71–2·45]) had a higher risk of death from malnutrition than did children of White mothers. Similar patterns were observed for death from diarrhoea (Indigenous, HR 14·28 [95% CI 12·25–16·65]; Black, HR 1·72 [1·44–2·05]; and Brown or Mixed race mothers, HR 1·78 [1·61–1·98]) and influenza and pneumonia (Indigenous, HR 6·49 [95% CI 5·78–7·27]; Black, HR 1·78 [1·62–1·96]; and Brown or Mixed race mothers, HR 1·60 [1·51–1·69]). Interpretation: Substantial ethnoracial inequalities were observed in child mortality in Brazil, especially among the Indigenous and Black populations. These findings demonstrate the importance of regular racial inequality assessments and monitoring. We suggest implementing policies to promote ethnoracial equity to reduce the impact of racism on child health.engElsevierDesigualdades étnico-raciaisMortalidade infantilBrasilEthnoracial inequalitiesChild mortalityBrazilSaúde das minorias étnicasMortalidade infantilBrasilEthnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babiesinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo: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/57272/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALRebouças,P.Ethnoracial inequalities..2022.pdfRebouças,P.Ethnoracial inequalities..2022.pdfapplication/pdf1095578https://www.arca.fiocruz.br/bitstream/icict/57272/2/Rebou%c3%a7as%2cP.Ethnoracial%20inequalities..2022.pdfaf05c34360acaecfdc50a63b849e9790MD52icict/572722023-03-15 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dc.title.en_US.fl_str_mv Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies
title Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies
spellingShingle Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies
Rebouças, Poliana
Desigualdades étnico-raciais
Mortalidade infantil
Brasil
Ethnoracial inequalities
Child mortality
Brazil
Saúde das minorias étnicas
Mortalidade infantil
Brasil
title_short Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies
title_full Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies
title_fullStr Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies
title_full_unstemmed Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies
title_sort Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies
author Rebouças, Poliana
author_facet Rebouças, Poliana
Goes, Emanuelle
Pescarini, Julia
Ramos, Dandara
Ichihara, Maria Yury
Sena, Samila
Veiga, Rafael
Rodrigues, Laura C.
Barreto, Maurício L.
Paixão, Enny S.
author_role author
author2 Goes, Emanuelle
Pescarini, Julia
Ramos, Dandara
Ichihara, Maria Yury
Sena, Samila
Veiga, Rafael
Rodrigues, Laura C.
Barreto, Maurício L.
Paixão, Enny S.
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Rebouças, Poliana
Goes, Emanuelle
Pescarini, Julia
Ramos, Dandara
Ichihara, Maria Yury
Sena, Samila
Veiga, Rafael
Rodrigues, Laura C.
Barreto, Maurício L.
Paixão, Enny S.
dc.subject.other.en_US.fl_str_mv Desigualdades étnico-raciais
Mortalidade infantil
Brasil
topic Desigualdades étnico-raciais
Mortalidade infantil
Brasil
Ethnoracial inequalities
Child mortality
Brazil
Saúde das minorias étnicas
Mortalidade infantil
Brasil
dc.subject.en.en_US.fl_str_mv Ethnoracial inequalities
Child mortality
Brazil
dc.subject.decs.en_US.fl_str_mv Saúde das minorias étnicas
Mortalidade infantil
Brasil
description Ministério da Ciência, Tecnologia e Inovação (MCTI). Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). Ministério da Saúde (MS); Secretaria de Ciência, Tecnologia, Inovação e Complexo da Saúde (SCTIE); Departamento de Ciência e Tecnologia (Decit). Bill & Melinda Gates Foundation's. Wellcome Trust.
publishDate 2022
dc.date.issued.fl_str_mv 2022
dc.date.accessioned.fl_str_mv 2023-03-08T13:29:41Z
dc.date.available.fl_str_mv 2023-03-08T13:29:41Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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status_str publishedVersion
dc.identifier.citation.fl_str_mv REBOUÇAS, Poliana et al. Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies. Lancet Glob Health, v. 10, n. 10, 2022.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/57272
dc.identifier.issn.en_US.fl_str_mv 2214-109X
dc.identifier.doi.none.fl_str_mv 10.1016/S2214-109X(22)00333-3
identifier_str_mv REBOUÇAS, Poliana et al. Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies. Lancet Glob Health, v. 10, n. 10, 2022.
2214-109X
10.1016/S2214-109X(22)00333-3
url https://www.arca.fiocruz.br/handle/icict/57272
dc.language.iso.fl_str_mv eng
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dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
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collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/57272/1/license.txt
https://www.arca.fiocruz.br/bitstream/icict/57272/2/Rebou%c3%a7as%2cP.Ethnoracial%20inequalities..2022.pdf
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repository.mail.fl_str_mv repositorio.arca@fiocruz.br
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