Inequality by Skin Color in Breast Cancer Screening in Brazil: a Differences-in-Differences Analysis of the COVID-19 Pandemic.

IF 3.2 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Racial and Ethnic Health Disparities Pub Date : 2025-04-01 Epub Date: 2024-01-16 DOI:10.1007/s40615-024-01908-2
Alana Ramos da Silva, Luiz Guilherme Dácar Silva Scorzafave
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Abstract

Breast cancer is the second most common cancer type and the first in mortality among Brazilian women. Mammograms are one of the main early diagnosis strategies. National breast cancer screening coverage is still low. Brazil's low screening coverage is due to high mammography access inequality. Skin color defines healthcare access differences. Our article explores the natural event of the COVID-19 pandemic to analyze differences in screening rates between two racial groups of women through the application of the differences in differences (DiD) estimator. The results indicate that BBI women (Black, Brown, and Indigenous Brazilian) have lower screening rates than WY women (White and Yellow) and that the pandemic reduced the difference between these two groups due to the lower number of mammograms performed by WY women. It is believed that the information channel can explain much of this result. The BA population, wealthier and more educated, may have had additional information about COVID-19 and its consequences, as well as an increased likelihood of working remotely and practicing social distance. Structural racism causes many social indicators to be correlated with inequality of access to mammography and negatively impacts health conditions for BBI women. Public policies are necessary for equal access to breast cancer screening for the most vulnerable women.

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巴西乳腺癌筛查中的肤色不平等:对 COVID-19 大流行病的差异分析。
在巴西妇女中,乳腺癌是第二大常见癌症类型,死亡率居首位。乳房 X 光检查是主要的早期诊断策略之一。全国乳腺癌筛查覆盖率仍然很低。巴西乳腺癌筛查覆盖率低的原因是乳房 X 射线照相术的普及程度很不平等。肤色决定了获得医疗服务的差异。我们的文章探讨了 COVID-19 大流行这一自然事件,通过应用差异估计法(DiD)分析了两个种族群体妇女筛查率的差异。结果表明,BBI 妇女(黑人、棕色人种和巴西土著人)的筛查率低于 WY 妇女(白人和黄种人),由于 WY 妇女进行乳房 X 光检查的次数较少,大流行缩小了这两个群体之间的差异。人们认为,信息渠道在很大程度上可以解释这一结果。BA 人口更富裕、受教育程度更高,他们可能掌握了更多有关 COVID-19 及其后果的信息,而且远程工作和保持社会距离的可能性也更大。结构性种族主义导致许多社会指标与乳腺 X 射线检查的不平等相关联,并对生物多样性妇女的健康状况产生了负面影响。公共政策对于最弱势妇女平等接受乳腺癌筛查是必要的。
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来源期刊
Journal of Racial and Ethnic Health Disparities
Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.30
自引率
5.10%
发文量
263
期刊介绍: Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.
期刊最新文献
Correction: Is It Safe for Me to Get It? Factors Influencing COVID-19 Vaccination Decision-Making among Postpartum Women Who Are Black and Hispanic in Deep South. Correction: Ending the HIV Epidemic in Black America: Qualitative Insights Following COVID-19. Inequality by Skin Color in Breast Cancer Screening in Brazil: a Differences-in-Differences Analysis of the COVID-19 Pandemic. COVID-19 and Challenging Working Environments: Experiences of Black Sub-Saharan African (BSSA) Front-Line Health Care Professionals Amid of COVID-19 Pandemic in the English Midlands Region. Moral Resilience and Race, Ethnicity, and Culture Within Healthcare Workers During the COVID-19 Pandemic in the USA: a Scoping Review.
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