Racial Disparities in Foot Examination among People with Diabetes in Brazil: A Nationwide Survey, 2019.

IF 3.4 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ethnicity & Disease Pub Date : 2024-10-22 eCollection Date: 2024-10-01 DOI:10.18865/EthnDis-2023-50

Clarice Nunes Bramante, Julia Soto Rizzato, Isabella Bagni Nakamura, Taís Freire Galvão, Marcus Tolentino Silva

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引用次数: 0

Abstract

Objective: To assess the absence of diabetic foot examination in Brazil and how ethnicity affected this outcome.

Design: This is an analysis of a nationwide survey held in Brazil in 2019. Participants with diabetes and that were 15 years of age or older were eligible for inclusion in the analysis. Adjusted Poisson regression with robust variance was used to calculate prevalence ratios (PRs) and 95% confidence intervals (95% CIs) of never having had the foot examined, with separate models according to ethnicity. Stata 14.2 was used for all calculations.

Results: We included 6216 individuals with diabetes; 52.1% (95%CI: 50.0%-54.2%) reported never having had their feet examined by a health care professional and 61% self-declared as Black (Black and Brown [Brazilian mixed race]). A higher frequency of negligence was observed among Black individuals (55.3%; 52.5%-58.1%) than among White individuals (48.2%; 45.0%-51.5%). Negligence was higher between 15- to 39-year-old participants (PR = 1.34, 1.14-1.57), lower educational level (PR = 1.37, 1.13-1.65), higher alcohol consumption (PR = 1.18, 1.06-1.31), fair health status (PR = 1.11, 1.01-1.21), and diabetes diagnosis of up to 10 years (PR = 1.42, 1.28-1.57). Among Blacks, tobacco use and other factors increased the frequency of the outcome, whereas participation in the Brazilian Unified Health System primary care program was a protection factor (P<.05).

Conclusion: Black Brazilians with diabetes had higher negligence of foot examination by health care professionals. Strengthening primary care would help mitigate systemic racism in Brazil.

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巴西糖尿病患者足部检查的种族差异：2019年全国调查

目的评估巴西糖尿病足检查的缺失情况以及种族对这一结果的影响：这是对 2019 年在巴西进行的一项全国性调查的分析。年龄在 15 岁或以上的糖尿病患者有资格参与分析。采用稳健方差调整泊松回归计算从未检查过足部的患病率（PRs）和 95% 置信区间（95% CIs），并根据种族建立不同的模型。所有计算均使用 Stata 14.2：我们共纳入了 6216 名糖尿病患者；52.1%（95%CI：50.0%-54.2%）的患者称从未接受过专业医护人员的足部检查，61%的患者自称为黑人（黑人和棕色人种[巴西混血]）。黑人的疏忽频率（55.3%；52.5%-58.1%）高于白人（48.2%；45.0%-51.5%）。15至39岁的参与者（PR=1.34，1.14-1.57）、教育程度较低（PR=1.37，1.13-1.65）、饮酒量较高（PR=1.18，1.06-1.31）、健康状况一般（PR=1.11，1.01-1.21）以及糖尿病诊断时间长达10年（PR=1.42，1.28-1.57）的人疏忽的比例更高。在黑人中，吸烟和其他因素增加了结果的发生频率，而参加巴西统一医疗系统初级保健计划则是一个保护因素（结论：巴西黑人糖尿病患者中，吸烟和其他因素增加了结果的发生频率，而参加巴西统一医疗系统初级保健计划则是一个保护因素：巴西黑人糖尿病患者较少接受医护人员的足部检查。加强初级保健将有助于减轻巴西的系统性种族主义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ethnicity & Disease 医学-公共卫生、环境卫生与职业卫生

CiteScore

6.30

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Ethnicity & Disease is an international journal that exclusively publishes information on the causal and associative relationships in the etiology of common illnesses through the study of ethnic patterns of disease. Topics focus on: ethnic differentials in disease rates;impact of migration on health status; social and ethnic factors related to health care access and health; and metabolic epidemiology. A major priority of the journal is to provide a forum for exchange between the United States and the developing countries of Europe, Africa, Asia, and Latin America.