Racial Residential Segregation and Cervical Cancer Mortality in Health Regions of Brazil
DOI:
https://doi.org/10.32635/2176-9745.RBC.2022v68n3.2458Keywords:
social segregation, uterine cervical neoplasms, spatial analysis, health status disparitiesAbstract
Introduction: Cervical cancer (CC) is one of the most common cancers in women and has been associated with low levels of development. Objective: To investigate the association between standardized CC mortality rate and racial residential segregation. Method: An ecological study that had as unit of analysis the 438 Health Regions in Brazil in 2010. The outcome was the mortality rate by CC in women, standardized by age, per 100,000 women. The exposure of interest was the Racial Interaction Index (RII), a measure of residential segregation in the uniformity dimension, estimated from 2010 Census data aggregated by census tracts. The Human Development Index (HDI) was a control covariate. The association between variables was analyzed using a linear regression model. Results: The mortality rate due to CC had the highest values in the health regions of the North and Midwest and the lowest in the South and Southeast, a pattern different from the HDI and RII, with lower numbers in the North and Northeast and higher in the South and Southeast. The RII had a negative association with the mortality rate; in the model adjusted by the HDI, each increase of 0.1 in the RII was associated with a decrease of 0.6 deaths per 100,000 women. Conclusion: Residential racial segregation is associated with mortality by CC. Residential segregation indicators should be considered for inclusion in future epidemiological studies outcomes as important contextual determinants of the health-disease process.
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