Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2016-10-10T22:19:59Z No. of bitstreams: 1 Dissertac?a?o_J_Smolen_PDF.pdf: 5008620 bytes, checksum: 417a8a5d29c91048ba70f7afe58d1578 (MD5) / Made available in DSpace on 2016-10-10T22:19:59Z (GMT). No. of bitstreams: 1 Dissertac?a?o_J_Smolen_PDF.pdf: 5008620 bytes, checksum: 417a8a5d29c91048ba70f7afe58d1578 (MD5) Previous issue date: 2016-02-15 / Mental disorders cause the largest burden of disability worldwide, and Common Mental Disorders (CMD) cause a significant burden to the community. Brazil has prioritized the health of Black population and the identification of racial disparities in health, yet few studies on mental health exist in Brazil that use race as a variable of analysis. Through a systematic review of the literature, these studies were identified to understand the association between race and mental health. No studies conducted an intersectional analysis of race and gender. The objective of this study is to examine the interaction between race, gender, and CMD in Feira de Santana, BA. This cross-sectional study used a representative sample of the urban population of 15 years or older in Feira de Santana. All those who self-identified as branco, preto, or pardo were included in the analysis. The Self-Report Questionnaire (SRQ-20) was used to determine the presence of CMD. Prevalence ratios for the four race/gender groups (white men, black men, white women, black women) were calculated using a Poisson regression, and an interaction analysis was performed to assess the contribution of the perspective of intersectionality. The results are presented in the form of journal articles. The systematic review is titled ?Race/skin color and mental health disorders in Brazil: a systematic review?, and the analytic article is entitled ?The perspective of intersectionality in quantitative health research: an analysis of the association between the intersections of race and gender, and Common Mental Disorders.? The systematic review showed that studies on mental health that assessed race often used different screening tools to identify the mental disorder and had small sample sizes of Afro-Brazilians; despite these problems, the overall trend shows a positive association between race and anxiety and/or depression. The results of the analytic article show that Black women had the highest prevalence of CMD of all the four race/gender groups, and even controlling for potential confounders Black women had a significantly higher prevalence of CMD, 2.43 times that of White men. The analysis of interaction shows the value of the intersectional perspective?that the prevalence seen in Black women is greater than would have been expected if examining race and gender separately. Determining the prevalence of TMC according to race and gender, and the association between these is essential to truly understand the racial disparities in CMD and for Brazil to fulfill its constitutional right of health for all. / Transtornos mentais causam a maior carga de incapacidade mundialmente, e Transtornos Mentais Comuns (TMC) causam uma carga significante na comunidade. O Brasil est? priorizando a sa?de da popula??o negra e a identifica??o de desigualdades raciais em sa?de, mas existem poucos estudos sobre sa?de mental no Brasil que inclu?ram a vari?vel ra?a/cor da pele como uma vari?vel de an?lise. Atrav?s de uma revis?o sistem?tica, esses estudos foram identificados para entender a rela??o entre ra?a/cor da pele e sa?de mental. Nenhum estudo realizou an?lises sobre a interseccionalidade de g?nero e ra?a com sa?de mental. O objetivo desse estudo ? avaliar a intera??o entre ra?a/cor da pele, g?nero, e TMC em Feira de Santana, BA. Esse estudo transversal utilizou uma amostra representativa da popula??o de 15 anos ou mais de idade na ?rea urbana de Feira de Santana. Todas as pessoas que se auto classificaram como branca, parda, ou preta foram inclu?das na an?lise. O Self Report Questionnaire (SRQ-20) determinou a presen?a de TMC. A preval?ncia de TMC segundo os quatro grupos de ra?a/g?nero (homens brancos, homens negros, mulheres brancas, mulheres negras) foram analisados atrav?s de raz?es de preval?ncia, calculados por regress?o de Poisson. Uma an?lise de intera??o foi realizada para examinar a contribui??o de interseccionalidade. Os resultados est?o apresentados na forma de artigo cient?fico. A revis?o sistem?tica tem o t?tulo ?Ra?a/cor da pele e transtornos mentais no Brasil?, e o artigo anal?tico tem o t?tulo ?A perspectiva de interseccionalidade na pesquisa quantitativa em sa?de: uma an?lise da associa??o entre as intersec??es de ra?a e g?nero e Transtornos Mentais Comuns?. A revis?o sistem?tica mostrou que estudos sobre sa?de mental que avaliaram ra?a/cor da pele muitas vezes usaram instrumentos diferentes e tiveram n?meros pequenos de pessoas negras; mesmo assim, no geral, esses estudos mostraram associa??o positiva entre a ra?a/cor da pele negra e transtornos mentais, como depress?o. Os resultados do artigo anal?tico mostraram que mulheres negras tiveram a preval?ncia mais alta de TMC de todos os quatro grupos de ra?a/g?nero, e quando ajustadas para covari?veis essa preval?ncia foi significantemente maior: 2,43 vezes maior que em homens brancos. A an?lise de intera??o mostrou o valor de utilizar a perspectiva interseccional. A preval?ncia nas mulheres negras foi maior do que era esperado em uma analise tradicional que trata de ra?a e g?nero como fatores separados e independentes. Entender a preval?ncia de TMC segundo ra?a/cor da pele e g?nero, e entender a associa??o entre essas vari?veis ? essencial para compreender as desigualdades raciais nos TMC e para o Brasil cumprir o direito constitucional ? sa?de para todos.

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In the United States there exists a clear and disconcerting racial disparity in the distribution of good health, which can be seen in differential levels of morbidity and mortality affecting blacks and whites. Previous research has examined the role of SES in shaping racial health disparities and recent studies have looked specifically at the effect of education on health to explain the racial disparity in health. Higher levels of education are robustly associated with good overall health for both blacks and whites and this association has been examined over the life-course. This research explores racial differences in the effect of education on health in general as well as over the life-course. Specifically, this paper examines race differences in the effects of education on health over the life-course. Pooled data from the National Health Interview Survey were analyzed using multivariate logistic regression to estimate the effects of race, education and age on health. The results of these analyses indicate that blacks receive lower education returns on their health than whites. The effect of education on health was shown to grow in the beginning of the life-course and diminish at the end of the life course in accordance with the mortality-as-leveler hypothesis. The black white health disparity was shown to grow over the life-course among the highly educated, whereas the disparity was consistent over the life-course for the poorly educated.

No description available.

BACKGROUND: Clinical evidence shows that diabetes may provoke uncontrolled blood pressure (BP) in hypertensive patients. However, racial differences in the associations of diabetes with uncontrolled BP outcomes among diagnosed hypertensive patients have not been evaluated. METHODS: A total of 6,134 diagnosed hypertensive subjects aged ≥ 20 years were collected from the National Health and Nutrition Examination Survey 1999-2008 with a stratified multistage design. Odds ratios (ORs) and relative ORs of uncontrolled BP and effect differences in continuous BP for diabetes over race/ethnicity were derived using weighted logistic regression and linear regression models. RESULTS: Compared with participants who did not have diabetes, non-Hispanic black participants with diabetes had a 138% higher chance of having uncontrolled BP, Mexican participants with diabetes had a 60% higher chance of having uncontrolled BP, and non-Hispanic white participants with diabetes had a 161% higher chances of having uncontrolled BP. The association of diabetes with uncontrolled BP was lower in Mexican Americans than in non-Hispanic blacks and whites (Mexican Americans vs. non-Hispanic blacks: relative OR = 0.55, 95% confidence interval (CI) = 0.37-0.82; Mexican Americans vs. non-Hispanic whites: relative OR = 0.53, 95% CI = 0.35-0.80) and the association of diabetes with isolated uncontrolled systolic BP was lower in Mexican Americans than in non-Hispanic whites (Mexican Americans vs. non-Hispanic whites: relative OR = 0.62, 95% CI = 0.40-0.96). Mexican Americans have a stronger association of diabetes with decreased systolic BP and diastolic BP than non-Hispanic whites, and a stronger association of diabetes with decreased diastolic BP than non-Hispanic blacks. CONCLUSIONS: The association of diabetes with uncontrolled BP outcomes is lower despite higher prevalence of diabetes in Mexican Americans than in non-Hispanic whites. The stronger association of diabetes with BP outcomes in whites should be of clinical concern, considering they account for the majority of the hypertensive population in the United States.