ArticleInternational journal for equity in health2024
Racial inequalities in the development of multimorbidity of chronic conditions: results from a Brazilian prospective cohort.
Article in International journal for equity in health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Prevalence of Chronic Non-Communicable Diseases according to Color/Race in Brazil: An Analysis of the 2019 National Health Survey.Journal of racial and ethnic health disparities · 2026Article
- Fifteen-Year Trends in Behavioral Risk Factors and Metabolic Health Conditions for Non-Communicable Diseases: Persistent Race and Gender Inequalities in Brazil.Journal of racial and ethnic health disparities · 2026Article
- Prevalence of chronic non-communicable diseases and multimorbidity among adults living in slums in Rio de Janeiro, Brazil: a population-based survey.International journal for equity in health · 2025Article
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8 authors.
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Abstract
backgroundThe occurrence of multimorbidity and its impacts have differentially affected population subgroups. Evidence on its incidence has mainly come from high-income regions, with limited exploration of racial disparities. This study investigated the association between racial groups and the development of multimorbidity and chronic conditions in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
methodsData from self-reported white, brown (pardos or mixed-race), and black participants at baseline of ELSA-Brasil (2008-2010) who were at risk for multimorbidity were analysed. The development of chronic conditions was assessed through in-person visits and self-reported diagnosis via telephone until the third follow-up visit (2017-2019). Multimorbidity was defined when, at the follow-up visit, the participant had two or more morbidities. Cumulative incidences, incidence rates, and adjusted incidence rate ratios (IRRs) were estimated using Poisson models.
resultsOver an 8.3-year follow-up, compared to white participants: browns had a 27% greater incidence of hypertension and obesity; and blacks had a 62% and 45% greater incidence, respectively. Blacks also had 58% more diabetes. The cancer incidence was greater among whites. Multimorbidity affected 41% of the participants, with a crude incidence rate of 57.5 cases per 1000 person-years (ranging from 56.3 for whites to 63.9 for blacks). Adjusted estimates showed a 20% higher incidence of multimorbidity in black participants compared to white participants (IRR: 1.20; 95% CI: 1.05-1.38).
conclusionsSignificant racial disparities in the risk of chronic conditions and multimorbidity were observed. Many associations revealed a gradient increase in illness risk according to darker skin tones. Addressing fundamental causes such as racism and racial discrimination, alongside considering social determinants of health, is vital for comprehensive multimorbidity care. Intersectoral, equitable policies are essential for ensuring health rights for historically marginalized groups.
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