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Racial inequalities in multimorbidity: baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
Oliveira, Fernanda Esthefane Garrides; Griep, Rosane Harter; Chor, Dora; Giatti, Luana; Machado, Luciana A C; Barreto, Sandhi Maria; da Costa Pereira, Alexandre; Fonseca, Maria de Jesus Mendes da; Bastos, Leonardo Soares.
Afiliação
  • Oliveira FEG; Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
  • Griep RH; Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Rio de Janeiro, Brazil. rohgriep@gmail.com.
  • Chor D; Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
  • Giatti L; Department of Preventive and Social Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
  • Machado LAC; Clinical Hospital/EBSERH, Federal University of Minas Gerais, Belo Horizonte, Brazil.
  • Barreto SM; Department of Preventive and Social Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
  • da Costa Pereira A; Heart Institute, University of São Paulo, São Paulo, Brazil.
  • Fonseca MJMD; Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
  • Bastos LS; Scientific Computing Program, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
BMC Public Health ; 22(1): 1319, 2022 07 09.
Article em En | MEDLINE | ID: mdl-35810284
BACKGROUND: 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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Grupos Raciais / Multimorbidade Tipo de estudo: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Limite: Aged / Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: BMC Public Health Assunto da revista: SAUDE PUBLICA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Grupos Raciais / Multimorbidade Tipo de estudo: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Limite: Aged / Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: BMC Public Health Assunto da revista: SAUDE PUBLICA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido