Iniquidade racial na mortalidade por câncer de colo de útero no Brasil: estudo de séries temporais de 2002 a 2021 / Racial iniquity in mortality from cervical cancer in Brazil: a time trend study from 2002 to 2021

Resumo O objetivo desse artigo é analisar séries temporais da mortalidade por câncer de colo do útero segundo raça/cor no Brasil de 2002 a 2021. Estudo ecológico de séries temporais com dados do Sistema de Informação sobre Mortalidade e informações populacionais do IBGE. Variações anuais das taxas de mortalidade ajustadas por idade de mulheres de 20 anos ou mais foram estimadas pelo modelo de regressão linear simples com correção de Prais-Winsten. Foram registrados 133.429 óbitos por câncer de colo de útero, destes, 51,2% foram de mulheres negras. As mulheres negras morrem mais e têm menor queda do coeficiente. Houve aumento da desigualdade racial ao longo dos anos. Em 2002, ocorriam 0,08 óbitos/100 mil mulheres a mais na população negra comparada com a população branca; em 2021 esse número é de aproximadamente 1 óbito. Para a elaboração de políticas de saúde da mulher devem ser consideradas as diferenças raciais na implementação de estratégias e metas.

Abstract This ecological study examined time series, from 2002 to 20121, of age-adjusted coefficients of cervical cancer mortality, in Brazil, in women aged 20 years or more, by race. The information sources were Brazil's mortality information system (Sistema de Informação sobre Mortalidade - SIM) and the official bureau of statistics (Instituto Brasileiro de Geografia e Estatística - IBGE). Annual changes in age-adjusted mortality rates were calculated using the Prais-Winsten linear regression method. Black women die more and the rate is decreasing less. Racial inequality has increased over the years. In 2002, there were 0.08 more deaths per 100,000 women in the black population than among white women; in 2021, the number was one death. Health policymaking should consider racial differences in the implementation of strategies and goals.

Fatores associados ao homicídio de mulheres no Brasil, segundo raça/cor, 2016-2020 / Factors associated with homicides of women in Brazil, by race or colour, 2016-2020

Resumo O objetivo deste estudo é avaliar as taxas de homicídios contra mulheres residentes no Brasil, segundo unidades da federação e raça/cor, no período de 2016 a 2020. Trata-se de um estudo ecológico de tendência temporal. Foi realizada análise múltipla adotando-se modelo de regressão para dados longitudinais. No período, ocorreram no Brasil 20.405 homicídios de mulheres e as taxas padronizadas mostraram que as mulheres negras (6,1/100.000) apresentaram as maiores taxas, em comparação às brancas (3,4/100.000). O Brasil apresentou queda de 25,2% de 2016 a 2020. A taxa de homicídio variou de 4,7 mortes por 100 mil mulheres em 2016 para 3,5 em 2020, mas a tendência decrescente e estatisticamente significante foi observada nas taxas de mulheres negras e brancas. As variáveis IDH, taxa de analfabetismo e proporção de causas mal definidas apresentaram uma relação inversa e estatisticamente significante com as taxas de homicídio de mulheres. Nos anos de 2019 e 2020 houve uma diminuição da taxa média de homicídio em relação ao ano de 2016. Apesar do decrescimento na evolução temporal das taxas para negras e brancas, houve diferenças raciais importantes nos homicídios de mulheres, com piores resultados para as mulheres negras.

Abstract This ecological, time-trend study examined rates of homicide against women residing in Brazil, by state and race/colour, from 2016 to 2020, by performing. Multiple analysis by regression model on longitudinal data. During the study period, 20,405 homicides of women were recorded in Brazil. Standardised homicides rates were higher among black women (6.1/100,000) than among white women (3.4/100,000). From 2016 to 2020, rates decreased 25.2%, from 4.7 deaths per 100,000 women in 2016 to 3.5 in 2020, with a statistically significant downward trend among both black and white women. Statistically significant inverse relationships were found between female homicide rates and HDI, illiteracy rate and proportion of ill-defined causes. The average homicide rate decreased in 2019 and 2020, as compared with 2016. Despite the decreasing time trend in homicide rates for both black and white women, they differed substantially by race, with worse outcomes for black women.

Nursing in Brazil: socioeconomic analysis with a focus on the racial composition / Enfermería en Brasil: análisis socioeconómicas con enfoque en la composición racial / Enfermagem no Brasil: análises socioeconômicas com foco na composição racial

ABSTRACT Objectives: to analyze the socioeconomic characteristics of nurses and nursing technicians living in Brazil according to color/race. Methods: based on the 2010 Demographic Census sample, 62,451 nursing professionals (nurses and technicians) living in Brazil were selected. Differences in monthly income were estimated by multivariate models, stratified by color or race groups (white, brown, and black). Results: the majority were technicians (61.9%) of white color (54.3%). The income of white nurses exceeded that of brown and black nurses by more than a quarter; among technicians, white professionals had an income approximately 11% higher than brown and black nurses. Conclusions: differences between incomes of nursing workers were associated with ethnic/racial background, revealing situations in which white professionals systematically presented more favorable job and income conditions than black and brown professionals.

RESUMEN Objetivos: analizar características socioeconómicas de enfermeros y técnicos de enfermería residentes en Brasil segundo color/raza. Métodos: con base en la muestra del Censo Demográfico 2010, fueron seleccionados 62.451 profesionales de enfermería (enfermeros y técnicos) residentes en Brasil. Diferencias de la renta mensual fueron estimadas por modelos multivariados, estratificados por grupos de color o raza (blanca, mestiza y negra). Resultados: la mayoría eran técnicos (61,9%) de color blanca (54,3%). La renta de enfermeros blancos superó en más de » a de los mestizos y negros; entre los técnicos, blancos tenían renta aproximadamente 11% mayor que la de mestizos y negros. Conclusiones: diferencias entre rendimientos de los trabajadores de la enfermería estaban relacionadas al pertenecer étnico-racial, revelando situaciones en las cuales profesionales de color/raza blanca presentaron, sistemáticamente, condiciones más favorables de trabajo y renta, en relación a los negros y mestizos.

RESUMO Objetivos: analisar características socioeconômicas de enfermeiros e técnicos de enfermagem residentes no Brasil segundo cor/raça. Métodos: com base na amostra do Censo Demográfico 2010, foram selecionados 62.451 profissionais de enfermagem (enfermeiros e técnicos) residentes noBrasil. Diferenças da renda mensal foram estimadas por modelos multivariados, estratificados por grupos de cor ou raça (branca, parda e preta). Resultados: a maioria eram técnicos (61,9%) de cor branca (54,3%). A renda de enfermeiros brancos superou em mais de » a dos pardos e pretos; entreos técnicos, brancos tinham renda aproximadamente 11% maior do que a de pardos e pretos. Conclusões: diferenças entre rendimentos dos trabalhadores da enfermagem estavam associadas ao pertencimento étnico-racial, revelando situações nas quais profissionais de cor/raça branca apresentaram, sistematicamente, condições mais favoráveis de trabalho e renda, em relação aos pretos e pardos.

Racial Differences in Hospital Stays among Patients Undergoing Craniotomy for Tumour Resection at a Single Academic Hospital

BACKGROUND: Racial differences in American patients undergoing brain tumour surgery remain poorly characterized within urban medical centres. Our objective was to assess racial differences in operative brain tumour patients at a single academic hospital in Los Angeles, California. METHODS: We reviewed medical records of adult patients undergoing craniotomy for tumour resection from March 2013 to January 2017 at UCLA Medical Centre. Patients were categorized as Asian, Hispanic, Black, or White. Racial cohorts were matched on demographic variables for comparisons. Our primary outcome was post-operative length of stay (LOS). Secondary outcomes included hospital mortality and discharge disposition. RESULTS: In this study, 462 patients identified as Asian (15.1%), Hispanic (8.7%), Black (3.9%), or White (72.3%). After cohort matching, non-White patients had elevated risk of prolonged LOS [odds ratio (OR)=2.62 (1.44, 4.76)]. No differences were observed in hospital mortality or non-routine discharge. Longer LOS was positively correlated with non-routine discharge [r(pb) (458)=0.41, p<0.001]. Black patients with government insurance had average LOS 2.84 days shorter than Black patients with private insurance (p=0.04). Among Hispanics, government insurance was associated with non-routine discharge [OR=4.93 (1.03, 24.00)]. CONCLUSION: Racial differences manifested as extended LOS for non-White patients, with comparable rates of hospital mortality and non-routine discharge across races. Prolonged LOS loosely reflected complicated clinical course with greater risk of adverse discharge disposition. Private insurance coverage predicted markedly lower risk of non-routine discharge for Hispanic patients, and LOS of three additional days among Black patients. Further research is needed to elucidate the basis of these differences.