دورية أكاديمية
Racial inequalities in the development of multimorbidity of chronic conditions: results from a Brazilian prospective cohort.
| العنوان: | Racial inequalities in the development of multimorbidity of chronic conditions: results from a Brazilian prospective cohort. |
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| المؤلفون: | Oliveira FEG; Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, 4365 Brazil Avenue, Manguinhos, Rio de Janeiro, 21040900, Brazil. fergarrides@gmail.com., Griep RH; Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Rio de Janeiro, Brazil., Chor D; Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, 4365 Brazil Avenue, Manguinhos, Rio de Janeiro, 21040900, Brazil., Barreto SM; Department of Preventive and Social Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil., Molina MDCB; Federal University of Espírito Santo, Vitória, Brazil., Machado LAC; Clinical Hospital/EBSERH, Federal University of Minas Gerais, Belo Horizonte, Brazil.; Executive Office, Science Integrity Alliance, Sunrise, Florida, US., Fonseca MJMD; Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, 4365 Brazil Avenue, Manguinhos, Rio de Janeiro, 21040900, Brazil., Bastos LS; Scientific Computing Program, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. |
| المصدر: | International journal for equity in health [Int J Equity Health] 2024 Jun 12; Vol. 23 (1), pp. 120. Date of Electronic Publication: 2024 Jun 12. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 101147692 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-9276 (Electronic) Linking ISSN: 14759276 NLM ISO Abbreviation: Int J Equity Health Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [London] : BioMed Central, 2002- |
| مواضيع طبية MeSH: | Multimorbidity*, Humans ; Brazil/epidemiology ; Female ; Male ; Middle Aged ; Prospective Studies ; Chronic Disease ; Adult ; Health Status Disparities ; Longitudinal Studies ; Aged ; Incidence ; White People/statistics & numerical data ; Socioeconomic Factors |
| مستخلص: | Background: The occurrence of multimorbidity and its impacts have differentially affected population subgroups. Evidence on its incidence has mainly come from high-income regions, with limited exploration of racial disparities. This study investigated the association between racial groups and the development of multimorbidity and chronic conditions in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods: Data from self-reported white, brown (pardos or mixed-race), and black participants at baseline of ELSA-Brasil (2008-2010) who were at risk for multimorbidity were analysed. The development of chronic conditions was assessed through in-person visits and self-reported diagnosis via telephone until the third follow-up visit (2017-2019). Multimorbidity was defined when, at the follow-up visit, the participant had two or more morbidities. Cumulative incidences, incidence rates, and adjusted incidence rate ratios (IRRs) were estimated using Poisson models. Results: Over an 8.3-year follow-up, compared to white participants: browns had a 27% greater incidence of hypertension and obesity; and blacks had a 62% and 45% greater incidence, respectively. Blacks also had 58% more diabetes. The cancer incidence was greater among whites. Multimorbidity affected 41% of the participants, with a crude incidence rate of 57.5 cases per 1000 person-years (ranging from 56.3 for whites to 63.9 for blacks). Adjusted estimates showed a 20% higher incidence of multimorbidity in black participants compared to white participants (IRR: 1.20; 95% CI: 1.05-1.38). Conclusions: Significant racial disparities in the risk of chronic conditions and multimorbidity were observed. Many associations revealed a gradient increase in illness risk according to darker skin tones. Addressing fundamental causes such as racism and racial discrimination, alongside considering social determinants of health, is vital for comprehensive multimorbidity care. Intersectoral, equitable policies are essential for ensuring health rights for historically marginalized groups. (© 2024. The Author(s).) |
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| معلومات مُعتمدة: | PhD grant Nota 10 E-26/200,636/2021 Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro; Scientist of Our State program Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro; Scientist of Our State program Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro; Young Scientist of Our State program E-26/201,277/2021 Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro; Productivity Scholarship Conselho Nacional de Desenvolvimento Científico e Tecnológico |
| فهرسة مساهمة: | Keywords: Aging; Health inequality monitoring; Health inequities; Longitudinal studies; Multimorbidity; Noncommunicable diseases; Racial inequalities in health; Racism; Social determinants of health Local Abstract: [Publisher, German] A ocorrência de multimorbidade e seus impactos têm afetado de forma diferenciada os subgrupos populacionais. As evidências sobre sua incidência provêm principalmente de regiões de alta renda, com exploração limitada das disparidades raciais. Este estudo investigou a associação entre grupos raciais e o desenvolvimento de multimorbidade e de condições crônicas no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). MéTODOS: Foram analisados dados de participantes autodeclarados brancos, pardos (raças mistas) e pretos na linha de base do ELSA-Brasil (2008-2010) que estavam em risco para a multimorbidade. O desenvolvimento de condições crônicas foi avaliado a partir das visitas presenciais e autorrelato de diagnóstico por telefone até a terceira visita de seguimento (2017-2019). A multimorbidade foi definida quando na visita de seguimento o participante possuía duas ou mais morbidades. Foram estimadas incidências acumuladas, taxas de incidência e razões das taxas de incidência (RTI) ajustadas a partir de modelos de Poisson. [Publisher, German] Em um acompanhamento de 8,3 anos, em comparação aos participantes brancos: os pardos tiveram uma incidência 27% maior de hipertensão e obesidade; e os pretos tiveram uma incidência 62% e 45% maior, respectivamente. Os pretos também tiveram 58% mais diabetes. A incidência de câncer foi maior entre os brancos. A multimorbidade afetou 41% dos participantes, com uma taxa bruta de incidência de 57,5 casos por 1.000 pessoas-ano (variando de 56,3 para brancos a 63,9 para pretos). Estimativas ajustadas mostraram incidência 20% maior de multimorbidade em pretos comparados aos brancos (RTI: 1,20; IC 95%: 1,05-1,38). CONCLUSõES: Foram observadas disparidades raciais significativas no risco de condições crônicas e multimorbidade. Muitas associações revelaram um aumento gradiente no risco de doenças de acordo com tons de pele mais escuros. Abordar causas fundamentais como o racismo e a discriminação racial, juntamente com a consideração dos determinantes sociais da saúde, é vital para o cuidado abrangente da multimorbidade. Políticas intersetoriais e equitativas são essenciais para a garantia do direito à saúde aos grupos historicamente marginalizados. |
| تواريخ الأحداث: | Date Created: 20240612 Date Completed: 20240613 Latest Revision: 20240615 |
| رمز التحديث: | 20240615 |
| مُعرف محوري في PubMed: | PMC11170781 |
| DOI: | 10.1186/s12939-024-02201-8 |
| PMID: | 38867238 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1475-9276 |
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| DOI: | 10.1186/s12939-024-02201-8 |