Who experiences discrimination in Brazil? Evidence from a large metropolitan region

James Macinko,Maria Fernanda Lima-Costa,Fernando A Proietti,Pricila Mullachery

doi:10.1186/1475-9276-11-80

Abstract

IntroductionPerceived discrimination is related to poor health and has been offered as one explanation for the persistence of health inequalities in some societies. In this study, we explore the prevalence and correlates of perceived discrimination in a large, multiracial Brazilian metropolitan area.MethodsThe study uses secondary analysis of a regionally representative household survey conducted in 2010 (n=12,213). Bivariate analyses and multiple logistic regression assess the magnitude and statistical significance of covariates associated with reports of any discrimination and with discrimination in specific settings, including when seeking healthcare services, in the work environment, in the family, in social occasions among friends or in public places, or in other situations.ResultsNearly 9% of the sample reported some type of discrimination. In multivariable models, reports of any discrimination were higher among people who identify as black versus white (OR 1.91), higher (OR 1.21) among women than men, higher (OR 1.33) among people in their 30’s and lower (OR 0.63) among older individuals. People with many health problems (OR 4.97) were more likely to report discrimination than those with few health problems. Subjective social status (OR 1.23) and low social trust (OR 1.27) were additional associated factors. Perceived discrimination experienced while seeking healthcare differed from all other types of discrimination, in that it was not associated with skin color, social status or trust, but was associated with sex, poverty, and poor health.ConclusionsThere appear to be multiple factors associated with perceived discrimination in this population that may affect health. Policies and programs aimed at reducing discrimination in Brazil will likely need to address this wider set of interrelated risk factors across different populations.

Highlights

Perceived discrimination is related to poor health and has been offered as one explanation for the persistence of health inequalities in some societies
Research points to a set of underlying mechanisms that may link experiencing discrimination with health inequalities, but there is much to be learned about how different risk factors for experiencing discrimination may interrelate and how they may differ in different settings [7,15,16,18]
Existing studies suggest that people who describe their skin color as other than white, women, less educated individuals, and sexual minorities are more likely to report having experienced some sort of discrimination [19,20,21,22]

Summary

Introduction

Perceived discrimination is related to poor health and has been offered as one explanation for the persistence of health inequalities in some societies. Experiences of discrimination, defined as manifestation of negative attitudes, judgments, or differential treatment on the basis of gender, race, social class, or other characteristics that disadvantages a social group,[1] have emerged as an important cause of poor health and one explanation for the persistence of health inequalities in some societies [2,3,4,5,6,7]. In Brazil, studies on perceived discrimination point to the importance of key demographic characteristics such as skin color, socio-economic status (SES), and gender. In a nationally-representative survey, nearly one tenth of recent users of outpatient health services reported feeling that they had been victims of some type of discrimination [20]

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