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Explaining racial disparities in infant health in Brazil

Kwame A Nyarko1, Jorge Lopez-Camelo1, Eduardo E Castilla1

  • 1Kwame A. Nyarko and George L. Wehby are with the Department of Health Management and Policy, University of Iowa, Iowa City. Jorge Lopez-Camelo and Eduardo E. Castilla are with Estudio Colaborativo Latino Americano de Malformaciones Congenitas (ECLAMC), Centro de Educación Médica e Investigación Clínica, Buenos Aires, Argentina, and ECLAMC, Laboratório de Epidemiologia de Malformações Congênitas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.

American Journal of Public Health
|August 28, 2015
PubMed

Insights

Racial disparities in low birth weight (LBW) and preterm birth (PTB) in Brazil are significantly explained by differences in prenatal care and geographic location. These factors, along with socioeconomic status, are key targets for policy interventions.

Area of Science:

  • Public Health
  • Epidemiology
  • Social Determinants of Health

Background:

  • Racial disparities in infant health outcomes, specifically low birth weight (LBW) and preterm birth (PTB), persist globally.
  • Understanding the contributing factors to these disparities is crucial for developing effective public health interventions in diverse populations like Brazil.

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 most significant contributors to the observed birth outcome disparities between infants of African ancestry and European ancestry in Brazil.

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) prevalence between infants of African ancestry (alone or mixed) and European ancestry.
  • Application of a decomposition model to assess the contribution of various factors to racial disparities in birth outcomes.

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 influential factors driving these disparities.
  • Socioeconomic differences also contributed significantly, with the model explaining the majority of disparities for mixed African ancestry and a portion for African ancestry alone.

Conclusions:

  • Public health policies aimed at reducing infant health disparities in Brazil should prioritize interventions addressing differences in prenatal care access and geographic location.
  • Targeting these key factors can help mitigate the significant birth outcome gaps between infants of African and European ancestries.
Abstract

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