Racial discrimination and health in Brazil: evidence from a population-based survey.

OBJECTIVE To investigate the association between racial discrimination and three health outcomes: self-rated health (SRH), physical morbidity and depression, in the Brazilian population. DESIGN Cross-sectional study based on data obtained from a representative national survey carried out in 2008: The Research for Social Dimension of Inequalities. PARTICIPANTS 3,863 household heads who classified themselves as Blacks or Mullatoes regarding their race and answered the entire research questionnaire. MAIN OUTCOME MEASURES Racial discrimination was measured through a scale of 9 domains based on a previously validated instrument and classified into two categories: no discrimination and any experience of racial discrimination. SRH was based on the question from the SF-36 quality of life instrument. Physical morbidity and depression were obtained from a list of chronic diseases from the questionnaire. Regression analysis was carried out for the three health outcomes controlling for socioeconomic, demographic, health behavior variables, and body mass index. RESULTS Racial discrimination was negatively associated with health for all evaluated outcomes. Any experience of racial discrimination was associated with 1.37 more chance of having worse SRH, 1.55 more chance of having more physical morbidities and 1.77 more chance of having depression, even after controlling for confounders. CONCLUSION An impact of racial discrimination on the health of the Brazilian population was found, regardless of the health indicator used, which revealed that depression was the health outcome with the most pronounced association.