Racial Disparities in Life Expectancy in Brazil: Challenges From a Multiracial Society

• Published in: American journal of public health (1971) Vol. 104; no. 11; pp. 2156 - 2162
• Main Authors: Chiavegatto Filho, Alexandre Dias Porto, Beltrán-Sánchez, Hiram, Kawachi, Ichiro
• Format: Journal Article
• Language: English
• Published: United States American Public Health Association 01.11.2014
• Subjects: 20th century; Adolescent; Adult; African Americans; African Continental Ancestry Group - statistics & numerical data; Age; Aged; Aged, 80 and over; Bias; Black people; Brazil - epidemiology; Cancer; Censuses; Child; Child, Preschool; Continental Population Groups - statistics & numerical data; Death & dying; Decomposition; Epidemiology; European Continental Ancestry Group - statistics & numerical data; Female; Health Status Disparities; Humans; Inequality; Infant; Life Expectancy; Life Tables; Male; Middle Aged; Missing data; Mortality; Multiracial people; Population; Public health; Race; Race/Ethnicity; Racial differences; Racial inequality; Research and Practice; Sensitivity analysis; Society; Socioeconomic Factors; Studies; White people; Womens health; Young Adult; Brazil
• ISSN: 0090-0036; 1541-0048; 1541-0048
• DOI: 10.2105/AJPH.2013.301565

Objectives. We calculated life expectancy at birth for Whites, Blacks, and mixed races in Brazil, and decomposed the differences by causes of death. Methods. We used Ministry of Health death records and 2010 Census population data (190 755 799 residents and 1 136 947 deaths). We applied the Arriaga methodology to calculate decomposition of life expectancy by cause of death. We performed sensitivity analyses for underreporting of deaths, missing data, and numerator–denominator bias. Results. Using standard life table methods, female life expectancy was highest for mixed races (78.80 years), followed by Whites (77.54 years), then Blacks (76.32 years). Male life expectancy was highest for Whites (71.10 years) followed closely by mixed races (71.08 years), and lower for Blacks (70.11 years). Homicides contributed the most to the relative life expectancy increase for Whites, and cancer decreased the gap. After adjustment for underreporting, missing data, and numerator–denominator bias, life expectancy was higher for Whites than for Blacks and mixed races. Conclusions. Despite wide socioeconomic differences between Whites and mixed races, standard life table methods showed that mixed races had higher life expectancy than Whites for women, and similar for men. With the increase of multiracial populations, measuring racial disparities in life expectancy will be a fast-growing challenge.