Ethnic Density and Premature Mortality by Skin Color/Race According to Levels of Urbanicity and Aggregation to the Metropolitan Regions of Brazilian Cities
Bruno Luciano Carneiro Alves de Oliveira1,2,* and Ronir Raggio Luiz1
1Institute for Studies in Public Health, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
2Medical School Coordenation, Federal University of Maranhão, Pinheiro, Brazil
Objective: Attributes of the social environment are associated with the health of racial groups, but it is still unknown whether ethnic density is one of the social properties of place that influence on the association between levels of urbanicity and aggregation to Metropolitan Regions (MR) of Brazilian cities, with mortality in white and dark-skinned (pardo and black) people.
Design: Ecological study which 508,560 deaths from 2010 according to skin color/race in white and dark-skinned people. Data from the Demographic Census of 2010 was used to establish levels of urbanicity and aggregation to MR, and categories of ethnic density for Brazilian cities. Urbanicity and aggregation to MR were grouped into six categories: Rural in MR, Rural out of MR, “Rurban” in MR, “Rurban” out of MR, Urban in MR, Urban out of MR. Four categories of ethnic density were used: pardo, mixed-race with dark-skinned majority, mixed-race with white majority, white. The risk of death was estimated by calculating Premature Mortality Rates (PMR) at 65 years of age, per 100,000 inhabitants and ageadjusted.
Results: To urbanicity and aggregation to MR, dark-skinned people presented the worst PMR. The highest values occurred in cities outside of MR, with increased rates in rural areas when compared to urban areas. When controlled by ethnic density, dark-skinned people had lower PMR in cities with white or mixed-race with white majority ethnic densities, and higher rates in all remaining densities and at all levels of urbanicity and aggregation to MR.
Conclusions: Ethnic density had an effect on health, it reduced the impact of place on PMR when the highest proportion of the population was of a racial group different to the racial group having the PMR measured. However, was not observed that white and dark-skinned people benefitted from an increased ethnic density of their own racial groups.
Premature mortality, urbanicity, social capital, distribution by race or ethnic group.