Does life-course socioeconomic position influence racial inequalities in the occurrence of uterine leiomyoma? Evidence from the Pro-Saude Study

Abstract

We aimed to investigate whether life-course socioeconomic position mediates the association between skin color/race and occurrence of uterine leiomyomas. We analyzed 1,475 female civil servants with baseline data (1999-2001) of the Pró-Saúde Study in Rio de Janeiro State, Brazil. Life-course socioeconomic position was determined by parental education (early life socioeconomic position), participant education (socioeconomic position in early adulthood) and their combination (cumulative socioeconomic position). Gynecological/breast exams and health insurance status were considered markers of access to health care. Hazard ratios (HR) and 95% confidence intervals (95%CI) were estimated using Cox proportional hazards models. Compared with white women, black and parda (“brown”) women had higher risk of reporting uterine leiomyomas, respectively HR: 1.6, 95%CI: 1.2-2.1; HR: 1.4, 95%CI: 0.8-2.5. Estimates were virtually identical in models including different variables related to life-course socioeconomic position. This study corroborated previous evidence of higher uterine leiomyomas risk in women with darker skin color, and further suggest that life-course socioeconomic position adversity does not influence this association.