The association between skin color/race and health indicators in elderly Brazilians: a study based on the Brazilian National Household Sample Survey (2008)

This study analyzed racial inequalities in health in 18,684 elderly Brazilians 65 years or older, interviewed in the National Household Sample Survey in 2008 (PNAD 2008), and who reported their color/race as white, brown, or black. Associations were estimated between self-rated health status, functional incapacity, and number of chronic conditions according to crude and adjusted regression analyses (α = 0.01). The majority of the elderly were white (56.2%). In the adjusted analysis, brown color/races was associated with worse self-rated health status (OR = 1.11; 95%CI: 1.03-1.18) and black color/race was associated with more chronic diseases (PR = 1.07; 95%CI: 1.02-1.13). Brown color/race appeared as a protective factor against functional incapacity. When brown and black elderly were combined in one category (“black”), “black” elderly continued to show worse self-rated health status (OR = 1.09; 95%CI: 1.02-1.16) and lower odds of functional incapacity (OR = 0.83; 95%CI: 0.76-0.92). “Black” color/race lost the association with number of chronic diseases. Color/race explained part of the health inequalities in elderly Brazilians, but other socioeconomic variables had a more striking effect.

本研究针对2008年全国家庭抽样调查（PNAD 2008）中受访的18684名65岁及以上巴西老年群体展开健康种族不平等分析，所有受访者均自述其肤色/种族为白人、棕种人或黑人。研究采用粗回归与校正回归分析（检验水准α=0.01），估算了自评健康状况、功能障碍与慢性疾病患病数量之间的关联。该老年群体中白人占比达56.2%，为群体主流。在校正回归分析中，棕种人自述者的自评健康状况更差（比值比Odds Ratio，OR=1.11；95%置信区间Confidence Interval，CI：1.03-1.18）；黑人自述者的慢性疾病患病数量更多（患病率比Prevalence Ratio，PR=1.07；95%CI：1.02-1.13），且棕种人自述者似乎是功能障碍的保护因素。当将棕种人与黑人合并为"黑人"一类时，该合并组老年群体仍表现出更差的自评健康状况（OR=1.09；95%CI：1.02-1.16），且功能障碍的发生风险更低（OR=0.83；95%CI：0.76-0.92），但该合并组不再与慢性疾病患病数量存在显著关联。肤色/种族可部分解释巴西老年群体的健康不平等现象，但其他社会经济变量对健康差异的影响更为显著。