Inequalities in the health, nutrition, and wellbeing of Afrodescendant women and children: A cross-sectional analysis of ten Latin American and Caribbean countries
Summary: Background: Afrodescendants are systematically affected by discrimination in the Americas and few multi-country studies addressed ethnic inequalities in health and wellbeing in the region. We aimed to investigate gaps in coverage of key health outcomes and socioeconomic inequalities betwee...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | The Lancet Regional Health. Americas |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667193X22001624 |
| _version_ | 1818000283777630208 |
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| author | Janaína Calu Costa Oscar J. Mujica Giovanna Gatica-Domínguez Sandra del Pino Liliana Carvajal Antonio Sanhueza Sonja Caffe Cesar G. Victora Aluísio J.D. Barros |
| author_facet | Janaína Calu Costa Oscar J. Mujica Giovanna Gatica-Domínguez Sandra del Pino Liliana Carvajal Antonio Sanhueza Sonja Caffe Cesar G. Victora Aluísio J.D. Barros |
| author_sort | Janaína Calu Costa |
| collection | DOAJ |
| description | Summary: Background: Afrodescendants are systematically affected by discrimination in the Americas and few multi-country studies addressed ethnic inequalities in health and wellbeing in the region. We aimed to investigate gaps in coverage of key health outcomes and socioeconomic inequalities between Afrodescendants and non-Afrodescendants populations in Latin American and Caribbean countries. Methods: Using national household surveys (2011–2019) from ten countries, we analyzed absolute inequalities between Afrodescendants and a comparison group that includes non-Afrodescendants and non-Indigenous individuals (henceforth non-Afrodescendants) across 17 indicators in the continuum of reproductive, maternal, newborn, child, and adolescent health. These include indicators of family planning, antenatal care, delivery assistance, child nutrition, immunization coverage, child protection, access to improved water, sanitation and hygiene, adolescent fertility, and early childhood mortality. Inequalities between country-specific subgroups of Afrodescendants were also explored. The slope index of inequality was used to assess wealth-based inequalities within each ethnic group. Findings: Afrodescendants represented from 2·8% (Honduras) to 59·1% (Brazil) of the national samples. Of the 128 combinations of country and indicators with data, Afrodescendants fared worse in 78 (of which 33 were significant) and performed better in 50 (15 significant). More systematic disadvantages for Afrodescendants were found for demand for family planning satisfied, early marriage, and household handwashing and sanitation facilities. In contrast, Afrodescendants tended to present lower c-section rates and lower stunting prevalence. Honduras was the only country where Afrodescendants performed better than non-Afrodescendants in several indicators. Wealth gaps among Afrodescendants were wider than those observed for non-Afrodescendants for most indicators and across all countries. Interpretation: Gaps in health outcomes between Afrodescendants and non-Afrodescendants were observed in most countries, with more frequent disadvantages for the former although, in many cases, the gaps were reversed. Wealth inequalities within Afrodescendants tended to be wider than for non-Afrodescendants. Funding: Pan American Health Organization, Bill and Melinda Gates Foundation, and the Wellcome Trust. |
| first_indexed | 2024-04-14T03:19:55Z |
| format | Article |
| id | doaj.art-3d3c42c4361a45ccb3602ba38551a28f |
| institution | Directory Open Access Journal |
| issn | 2667-193X |
| language | English |
| last_indexed | 2024-04-14T03:19:55Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Americas |
| spelling | doaj.art-3d3c42c4361a45ccb3602ba38551a28f2022-12-22T02:15:20ZengElsevierThe Lancet Regional Health. Americas2667-193X2022-11-0115100345Inequalities in the health, nutrition, and wellbeing of Afrodescendant women and children: A cross-sectional analysis of ten Latin American and Caribbean countriesJanaína Calu Costa0Oscar J. Mujica1Giovanna Gatica-Domínguez2Sandra del Pino3Liliana Carvajal4Antonio Sanhueza5Sonja Caffe6Cesar G. Victora7Aluísio J.D. Barros8International Center for Equity in Health, Federal University of Pelotas, Brazil; Corresponding author at: 1160 Marechal Deodoro, 3rd floor, Pelotas, RS, 96020-220, Brazil.Pan American Health Organization, Washington D.C., USAInternational Center for Equity in Health, Federal University of Pelotas, BrazilPan American Health Organization, Washington D.C., USADivision of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York, USA; Department of Global Public Health, Karolinska Institutet, Stockholm, SwedenPan American Health Organization, Washington D.C., USAPan American Health Organization, Washington D.C., USAInternational Center for Equity in Health, Federal University of Pelotas, BrazilInternational Center for Equity in Health, Federal University of Pelotas, BrazilSummary: Background: Afrodescendants are systematically affected by discrimination in the Americas and few multi-country studies addressed ethnic inequalities in health and wellbeing in the region. We aimed to investigate gaps in coverage of key health outcomes and socioeconomic inequalities between Afrodescendants and non-Afrodescendants populations in Latin American and Caribbean countries. Methods: Using national household surveys (2011–2019) from ten countries, we analyzed absolute inequalities between Afrodescendants and a comparison group that includes non-Afrodescendants and non-Indigenous individuals (henceforth non-Afrodescendants) across 17 indicators in the continuum of reproductive, maternal, newborn, child, and adolescent health. These include indicators of family planning, antenatal care, delivery assistance, child nutrition, immunization coverage, child protection, access to improved water, sanitation and hygiene, adolescent fertility, and early childhood mortality. Inequalities between country-specific subgroups of Afrodescendants were also explored. The slope index of inequality was used to assess wealth-based inequalities within each ethnic group. Findings: Afrodescendants represented from 2·8% (Honduras) to 59·1% (Brazil) of the national samples. Of the 128 combinations of country and indicators with data, Afrodescendants fared worse in 78 (of which 33 were significant) and performed better in 50 (15 significant). More systematic disadvantages for Afrodescendants were found for demand for family planning satisfied, early marriage, and household handwashing and sanitation facilities. In contrast, Afrodescendants tended to present lower c-section rates and lower stunting prevalence. Honduras was the only country where Afrodescendants performed better than non-Afrodescendants in several indicators. Wealth gaps among Afrodescendants were wider than those observed for non-Afrodescendants for most indicators and across all countries. Interpretation: Gaps in health outcomes between Afrodescendants and non-Afrodescendants were observed in most countries, with more frequent disadvantages for the former although, in many cases, the gaps were reversed. Wealth inequalities within Afrodescendants tended to be wider than for non-Afrodescendants. Funding: Pan American Health Organization, Bill and Melinda Gates Foundation, and the Wellcome Trust.http://www.sciencedirect.com/science/article/pii/S2667193X22001624Ethnic and racial disparitiesHealth equityChild healthMaternal healthLatin America and the Caribbean |
| spellingShingle | Janaína Calu Costa Oscar J. Mujica Giovanna Gatica-Domínguez Sandra del Pino Liliana Carvajal Antonio Sanhueza Sonja Caffe Cesar G. Victora Aluísio J.D. Barros Inequalities in the health, nutrition, and wellbeing of Afrodescendant women and children: A cross-sectional analysis of ten Latin American and Caribbean countries The Lancet Regional Health. Americas Ethnic and racial disparities Health equity Child health Maternal health Latin America and the Caribbean |
| title | Inequalities in the health, nutrition, and wellbeing of Afrodescendant women and children: A cross-sectional analysis of ten Latin American and Caribbean countries |
| title_full | Inequalities in the health, nutrition, and wellbeing of Afrodescendant women and children: A cross-sectional analysis of ten Latin American and Caribbean countries |
| title_fullStr | Inequalities in the health, nutrition, and wellbeing of Afrodescendant women and children: A cross-sectional analysis of ten Latin American and Caribbean countries |
| title_full_unstemmed | Inequalities in the health, nutrition, and wellbeing of Afrodescendant women and children: A cross-sectional analysis of ten Latin American and Caribbean countries |
| title_short | Inequalities in the health, nutrition, and wellbeing of Afrodescendant women and children: A cross-sectional analysis of ten Latin American and Caribbean countries |
| title_sort | inequalities in the health nutrition and wellbeing of afrodescendant women and children a cross sectional analysis of ten latin american and caribbean countries |
| topic | Ethnic and racial disparities Health equity Child health Maternal health Latin America and the Caribbean |
| url | http://www.sciencedirect.com/science/article/pii/S2667193X22001624 |
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