ArticleBMJ global health2023
Racial inequalities in mental healthcare use and mortality: a cross-sectional analysis of 1.2 million low-income individuals in Rio de Janeiro, Brazil 2010-2016.
Article in BMJ global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Sociodemographic Factors and Determinants of Mental Health in the African American Population A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2026Article
- Mapping the expressions and impacts of racism on health in Brazil: a scoping review.Lancet regional health. Americas · 2026Review
- Hospital mortality among psychiatric inpatients: a cross-sectional study, Brazil, 2023.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2026Article
- Dementia and cognitive decline in Black Brazilians: a narrative review.Frontiers in human neuroscience · 2026Review
- Racial inequalities in access to healthcare services in Brazil (2019): a decomposition analysis.BMC health services research · 2025Observational
- Governance for anti-racist AI in healthcare: integrating racism-related stress in psychiatric algorithms for Black Americans.Frontiers in digital health · 2025Article
- Is digital psychiatry really for all? A cross-sectional analysis from two randomized clinical trials.Trends in psychiatry and psychotherapy · 2025Article
- Improvements in data completeness in health information systems reveal racial inequalities: longitudinal national data from hospital admissions in Brazil 2010-2022.International journal for equity in health · 2024Article
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9 authors.
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Abstract
introductionMental health inequalities across racial and ethnic groups are large and unjust in many countries, yet these inequalities remain under-researched, particularly in low-income and middle-income countries such as Brazil. This study investigates racial and socioeconomic inequalities in primary healthcare usage, hospitalisation and mortality for mental health disorders in Rio de Janeiro, Brazil.
methodsA cohort of 1.2 million low-income adults from Rio de Janeiro, Brazil with linked socioeconomic, demographic, healthcare use and mortality records was cross-sectionally analysed. Poisson regression models were used to investigate associations between self-defined race/colour and primary healthcare (PHC) usage, hospitalisation and mortality due to mental disorders, adjusting for socioeconomic factors. Interactions between race/colour and socioeconomic characteristics (sex, education level, income) explored if black and pardo (mixed race) individuals faced compounded risk of adverse mental health outcomes.
resultsThere were 272 532 PHC consultations, 10 970 hospitalisations and 259 deaths due to mental disorders between 2010 and 2016. After adjusting for a wide range of socioeconomic factors, the lowest PHC usage rates were observed in black (adjusted rate ratio (ARR): 0.64; 95% CI 0.60 to 0.68; compared with white) and pardo individuals (ARR: 0.87; 95% CI 0.83 to 0.92). Black individuals were more likely to die from mental disorders (ARR: 1.68; 95% CI 1.19 to 2.37; compared with white), as were those with lower educational attainment and household income. In interaction models, being black or pardo conferred additional disadvantage across mental health outcomes. The highest educated black (ARR: 0.56; 95% CI 0.47 to 0.66) and pardo (ARR: 0.75; 95% CI 0.66 to 0.87) individuals had lower rates of PHC usage for mental disorders compared with the least educated white individuals. Black individuals were 3.7 times (ARR: 3.67; 95% CI 1.29 to 10.42) more likely to die from mental disorders compared with white individuals with the same education level.
conclusionIn low-income individuals in Rio de Janeiro, racial/colour inequalities in mental health outcomes were large and not fully explainable by socioeconomic status. Black and pardo Brazilians were consistently negatively affected, with lower PHC usage and worse mental health outcomes.
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