0234/2021 - Iniquidades raciais no acesso à reabilitação após acidente vascular cerebral: Estudo da população brasileira Racial iniquities in access to rehabilitation after stroke: study of the Brazilian population
Objetivo: Verificar a associação raça/cor e acesso a serviços de reabilitação pós-AVC. Método: Estudo transversal de base populacional com 966 adultos (? 18 anos) pós-AVC, respondentes da Pesquisa Nacional de Saúde. Desfecho, acesso à reabilitação, e exposição (raça/cor) foram coletados de modo autorreferido. Variáveis sociodemográficas, histórico clínico, plano de saúde e limitação pós-AVC foram considerados para o ajuste. Regressão de Poisson com estimativa de variância robusta foi utilizada para estimar a associação nas análises bruta e ajustada. Resultados: Da amostra total, 51,8% são autodeclarados negros ou outras raças, 61,4% demandam por reabilitação, sendo que apenas 20% têm acesso ao serviço de reabilitação. Dificuldade em acessar reabilitação foi referida por 57,5% dos autodeclarados amarelos ou indígenas, 43% dos negros, e 35,4% dos brancos. Na análise ajustada, negros têm 4% menos acesso à reabilitação se comparados com seus pares brancos (RP 1,04, IC95%1,00-1,08). Pessoas da raça amarela ou indígena 17% menos acesso que brancos (RP 1,17, IC95%1,13-1,20). Conclusão: No Brasil, autodeclarados negros, amarelos, indígenas e outros têm pior acesso à reabilitação pós-AVC quando comparados aos autodeclarados brancos, apontando iniquidades raciais na reabilitação em sobreviventes de AVC.
Objective: To verify the association between race/skin color and access to post-stroke rehabilitation services. Methods: Cross-sectional population-based study including 966 adults (≥ 18 years) post-stroke that responded to the National Health Survey (PNS). The outcome, access to rehabilitation, and exposure (race/skin color) were collected in a self-reported manner. For the adjustment were considered socio-demographic variables, clinical history, healthcare plan and post-stroke limitation. Poisson regression with robust variance estimation was used to estimate the association in the crude and adjusted analyzes. Results: Based on the sample, 51.8% are self-declared black or of other races, and 61.4% demand rehabilitation, with only 20% having access to the rehabilitation service. Difficulty in accessing rehabilitation was reported by 57.5% of self-declared other races, 43% blacks, and 35.4% whites. In the adjusted analysis, 4% of self-declared black (PR 1.04, CI95%1.00-1.08) and 17% of self-declared yellow and indigenous (PR 1.17, IC95%1.13-1.20) have less access to rehabilitation when compared to their white peers. Conclusion: In Brazil, self-declared black and yellow and indigenous have worst access to post-stroke rehabilitation when compared to self-declared white, pointing out racial inequities in rehabilitation in stroke survivors.
Racial iniquities in access to rehabilitation after stroke: study of the Brazilian population
Resumo (abstract):
Objective: To verify the association between race/skin color and access to post-stroke rehabilitation services. Methods: Cross-sectional population-based study including 966 adults (≥ 18 years) post-stroke that responded to the National Health Survey (PNS). The outcome, access to rehabilitation, and exposure (race/skin color) were collected in a self-reported manner. For the adjustment were considered socio-demographic variables, clinical history, healthcare plan and post-stroke limitation. Poisson regression with robust variance estimation was used to estimate the association in the crude and adjusted analyzes. Results: Based on the sample, 51.8% are self-declared black or of other races, and 61.4% demand rehabilitation, with only 20% having access to the rehabilitation service. Difficulty in accessing rehabilitation was reported by 57.5% of self-declared other races, 43% blacks, and 35.4% whites. In the adjusted analysis, 4% of self-declared black (PR 1.04, CI95%1.00-1.08) and 17% of self-declared yellow and indigenous (PR 1.17, IC95%1.13-1.20) have less access to rehabilitation when compared to their white peers. Conclusion: In Brazil, self-declared black and yellow and indigenous have worst access to post-stroke rehabilitation when compared to self-declared white, pointing out racial inequities in rehabilitation in stroke survivors.
Souto, S. da R., Anderle, P., Goulart, B.N.G.. Iniquidades raciais no acesso à reabilitação após acidente vascular cerebral: Estudo da população brasileira. Cien Saude Colet [periódico na internet] (2021/Jul). [Citado em 08/09/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/iniquidades-raciais-no-acesso-a-reabilitacao-apos-acidente-vascular-cerebral-estudo-da-populacao-brasileira/18133?id=18133&id=18133
