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Explaining racial disparities in infant health in Brazil

Kwame A Nyarko1, Jorge Lopez-Camelo, Eduardo E Castilla

  • 1Department of Health Management and Policy, University of Iowa, Iowa City, IA 52242, USA.

American Journal of Public Health
|February 16, 2013
PubMed

Insights

Racial disparities in low birth weight (LBW) and preterm birth (PTB) in Brazil are significantly influenced by prenatal care access and geographic factors. Addressing these can reduce adverse birth outcomes for African ancestry infants.

Area of Science:

  • Public Health
  • Perinatal Epidemiology
  • Health Disparities Research

Background:

  • Racial disparities in infant health outcomes, specifically low birth weight (LBW) and preterm birth (PTB), are a significant concern in Brazil.
  • Understanding the multifactorial nature of these disparities is crucial for developing targeted interventions.

Purpose of the Study:

  • To quantify the extent to which socioeconomic, healthcare, demographic, and geographic factors explain racial disparities in LBW and PTB rates in Brazil.
  • To identify the primary drivers of these disparities between infants of African and European ancestries.

Main Methods:

  • Analysis of a large sample (n=8949) of infants born between 1995-2009 across 15 cities and 7 provinces in Brazil.
  • Focus on disparities in LBW (<2500g) and PTB (<37 weeks) between infants of African ancestry (alone or mixed) and European ancestry.
  • Application of a decomposition model to assess the contribution of various factors to observed racial disparities.

Main Results:

  • The decomposition model explained a substantial portion of the disparities, ranging from 45% to 94% for LBW and 64% to 94% for PTB.
  • Differences in prenatal care utilization and geographic location emerged as the most significant contributors to these disparities.
  • Socioeconomic factors also played a notable role, with the model accounting for the majority of disparities in mixed African ancestry groups and a portion in African ancestry alone groups.

Conclusions:

  • Public health policies in Brazil should prioritize interventions targeting improvements in prenatal care access and addressing geographic disparities.
  • These targeted strategies are essential for effectively reducing adverse birth outcomes and health inequities between infants of African and European ancestries.
Abstract

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