Explaining Racial Disparities in Infant Health in Brazil
Explaining Racial Disparities in Infant Health in Brazil
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DOI：
10.2105/ajph.2012.301021
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发表时间：
2013-09-01
影响因子：
12.7
通讯作者：
Wehby, George L.
中科院分区：
文献类型：
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作者：
Nyarko, Kwame A.;Lopez-Camelo, Jorge;Wehby, George L.
目标.我们试图量化社会经济、卫生保健、人口统计学和地理因素如何解释巴西低出生体重（LBW）和早产（PTB）率的种族差异。我们在巴西的15个城市和7个省的1995年至2009年期间出生的8949名婴儿的样本。我们关注的是仅非洲血统或非洲与其他血统混合的婴儿与仅欧洲血统的婴儿之间LBW（< 2500 g）和PTB（< 37孕周）患病率的差异。我们使用了一个分解模型来量化概念上相关的因素对这些风险的贡献。该模型解释了非洲血统群体和欧洲血统群体之间45%至94%的LBW和64%至94%的PTB差异。产前护理使用和地理位置的差异是最重要的贡献者，其次是社会经济差异。该模型解释了混合非洲血统的大部分差异和非洲血统单独的部分差异。改善儿童健康的公共政策应针对产前护理和地理位置差异，以减少巴西非洲裔和欧洲裔婴儿之间的健康差距。
Objectives. We sought to quantify how socioeconomic, health care, demographic, and geographic effects explain racial disparities in low birth weight (LBW) and preterm birth (PTB) rates in Brazil.Methods. We employed a sample of 8949 infants born between 1995 and 2009 in 15 cities and 7 provinces in Brazil. We focused on disparities in LBW (< 2500 g) and PTB (< 37 gestational weeks) prevalence between infants of African ancestry alone or African mixed with other ancestries, and European ancestry alone. We used a decomposition model to quantify the contributions of conceptually relevant factors to these disparities.Results. The model explained 45% to 94% of LBW and 64% to 94% of PTB disparities between the African ancestry groups and European ancestry. Differences in prenatal care use and geographic location were the most important contributors, followed by socioeconomic differences. The model explained the majority of the disparities for mixed African ancestry and part of the disparity for African ancestry alone.Conclusions. Public policies to improve children's health should target prenatal care and geographic location differences to reduce health disparities between infants of African and European ancestries in Brazil.