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Published on: January 12, 2018
Racial disparities in life expectancy in Brazil: challenges from a multiracial society
Alexandre Dias Porto Chiavegatto Filho1, Hiram Beltrán-Sánchez, Ichiro Kawachi
1Alexandre Dias Porto Chiavegatto Filho is with the Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil, and the Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA. Hiram Beltrán-Sánchez is with the Center for Population and Development Studies, Harvard School of Public Health. Ichiro Kawachi is with the Department of Social and Behavioral Sciences, Harvard School of Public Health.
Objectives:
We calculated life expectancy at birth for Whites, Blacks, and mixed races in Brazil, and decomposed the differences by causes of death.
Methods:
We used Ministry of Health death records and 2010 Census population data (190,755,799 residents and 1,136,947 deaths). We applied the Arriaga methodology to calculate decomposition of life expectancy by cause of death. We performed sensitivity analyses for underreporting of deaths, missing data, and numerator-denominator bias.
Results:
Using standard life table methods, female life expectancy was highest for mixed races (78.80 years), followed by Whites (77.54 years), then Blacks (76.32 years). Male life expectancy was highest for Whites (71.10 years) followed closely by mixed races (71.08 years), and lower for Blacks (70.11 years). Homicides contributed the most to the relative life expectancy increase for Whites, and cancer decreased the gap. After adjustment for underreporting, missing data, and numerator-denominator bias, life expectancy was higher for Whites than for Blacks and mixed races.
Conclusions:
Despite wide socioeconomic differences between Whites and mixed races, standard life table methods showed that mixed races had higher life expectancy than Whites for women, and similar for men. With the increase of multiracial populations, measuring racial disparities in life expectancy will be a fast-growing challenge.
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