Artigos

Conteúdo (article):

Necropolitics and the impact of COVID-19 on the Black community in Brazil: a literature review and a document analysis

Necropolítica e reflexões acerca da população negra no contexto da pandemia da
COVID-19 no Brasil: uma revisão bibliográfica

Hebert Luan Pereira Campos dos Santos1, Fernanda Beatriz Melo Maciel2, Kênia Rocha Santos3, Cídia Dayara Vieira Silva da Conceição4, Rian Silva de Oliveira5, Natiene Ramos Ferreira da Silva6, Nília Maria de Brito Lima Prado7
1 MD. student, Federal University of Bahia (UFBA) - Instituto Multidisciplinar em Saúde - Campus Anísio Teixeira. Postal address Rua Hormindo Barros, 58, Quadra, bairro Candeias - CEP: 45.029-094, Vitória da Conquista - Bahia – Brasil, ohebertluan@gmail.com
2 MD. student, Federal University of Bahia (UFBA) - Instituto Multidisciplinar em Saúde - Campus Anísio Teixeira. Postal address: Rua Hormindo Barros, 58, Quadra, bairro Candeias - CEP: 45.029-094,Vitória da Conquista – Bahia – Brasil, fernandamlmcl728@gmail.com, https://orcid.org/0000-0002-6421-3940
3 MD. student, Federal University of Bahia (UFBA) - Instituto Multidisciplinar em Saúde - Campus Anísio Teixeira. Postal address: Rua Hormindo Barros, 58, Quadra, bairro Candeias - CEP: 45.029-094,Vitória da Conquista – Bahia – Brasil, keniarocha02@gmail.com, https://orcid.org/0000-0002-2396-5353
4 M.A student in Public Law, Federal University of Bahia (UFBA) – Faculdade de Direito, Rua da Paz, S/N - Graça, Salvador - BA, 40231-300, cdvscadvogada@gmail.com, https://orcid.org/0000-0002-4277-9679
5 Nutrition student, Federal University of Bahia (UFBA) - Instituto Multidisciplinar em Saúde - Campus Anísio Teixeira. Postal address: Rua Hormindo Barros, 58, Quadra, bairro Candeias - CEP: 45.029-094,Vitória da Conquista – Bahia – Brasil, riansilvak@gmail.com, https://orcid.org/0000-0002-2162-1302X
6 MA student, Psychology, Federal University of Bahia (UFBA) Bahia - Instituto Multidisciplinar em Saúde - Campus Anísio Teixeira., Psicóloga Clínica na Universidade Federal da Bahia. Postal adrress: Rua Hormindo Barros, 58, Quadra, bairro Candeias - CEP: 45.029-094, Vitória da Conquista – Bahia – Brasil, ramosnatiene@gmail.com, https://orcid.org/0000-0001-5809-209X
7 Professor at the Federal University of Bahia (UFBA) - Instituto Multidisciplinar em Saúde - Campus Anísio Teixeira. Endereço postal: Rua Hormindo Barros, 58, Quadra, bairro Candeias - CEP: 45.029-094, Vitória da Conquista – Bahia – Brasil, nilia.prado@ufba.br, https://orcid.org/0000-0001-8243-5662

Abstract
This study discusses to what extent the inclusion, or not, of the race/color variable in epidemiological analysis of the COVID-19 pandemic can work as an external manifestation of necropolitics and as a producer of health inequities. We conducted a literature review on 09 articles, and on Scientific Electronic Library, PubMed and Virtual Health Library databases. We also conducted a documental analysis on 27 epidemiological reports from all the federal states and the Federal District of Brazil. We did not see much information regarding race/color, which can be interpreted as an intentional omission in order to hide those who the epidemics affects the most. The denial of basic and fundamental rights is the element that characterizes the larger racist structure of Brazil\'s COVID-19 policies.
Keywords: racism; black population; health equity; pandemic; COVID-19.
Resumo
Com o objetivo de discutir em que medida a inclusão ou não da variável raça/cor nas análises epidemiológicas da pandemia da COVID-19 manifesta-se como mecanismo de efetivação da necropolítica e como produtor de iniquidades (injustas e evitáveis) em saúde foi realizada uma revisão bibliográfica a partir da revisão da literatura científica nas bases de dados Scientific Eletronic Library, PubMed e Biblioteca Virtual de Saúde incluindo 09 artigos e análise documental de 27 boletins epidemiológicos de todos os estados brasileiros e Distrito Federal. Observou-se incipiência de dados relacionados a raça/cor, o que pode revelar a pretensão de invisibilizar quem são os mais atingidos pela epidemia. A negação dos direitos básicos e fundamentais caracteriza a estrutura racista que tem operado a política de enfrentamento da COVID-19 no país.
Palavras-chave: racismo; população negra; equidade em saúde; pandemia; covid-19.

Introduction
On March 11, 2020, due to the COVID-19 fast dissemination in many continents, the World Health Organization (WHO) declared it pandemic. Although the disease is considered a global threat - a danger to everyone - it is known that its propagation affects specific social groups in different ways.¹ Baqui et al.² analyzed the Brazilian Influenza Epidemiological Surveillance Information System, and it pointed out that non-white people are at higher risk of dying from COVID-19.
The effectiveness of the preventive measures that the Ministry of Health recommended are unrealistic for low-income Brazilians. These are policies that maximize existing social inequalities. A large portion of the Brazilian population, for example, has neither access to water nor money to buy and use hand sanitizers. Informal economy and "favelas" are also obstacles to implement the WHO recommendations which Brazilian states have adopted and enforced, such as social distancing³.
According to the Brazilian Institute of Geography and Statistics (IBGE)4, non-white people are more affected by social restrictions. An analysis that took into consideration race/color showed that 47,3% of black people in Brazil work in informal economy compared to 34,6% of white people. Moreover, black people\'s per capita home income is R$ 934.00, while white people\'s is R$1,846.00.
The pandemic in Brazil exposes and exacerbates historical problems that affect not only Brazil’s public health, but also its economy, general structure, and politics. Brazil is considered a multiethnic country, but its history reveals a racist structure that subjugates and circumscribes black people to the edges of public policies.7-9 The pandemic enhanced the existing overlap of social and racial inequalities in Brazil.5-7
It is essential to recognize that identifying the morbimortality epidemiological profile, especially during public health emergencies, is fundamental to outline public policies that could mitigate these emergencies8. However, the COVID-19 data gathered in the country reveals that the shortage of race/color data makes it impossible to verify the impact of the pandemic on this population accurately, and it hinders the development of specific strategies.9
The non-inclusion of this variable on daily COVID-19 epidemiological reports corroborates with what several authors10-13 say about the lack and/or incompleteness of the race/color variable in the epidemiology, public health, and health social sciences fields. The position adopted by the State during the pandemic denounces the unfair, avoidable, unacceptable, and inhuman character that the public health policies can undertake.14
Based on the premises of the social determinants of health, this article focuses on discussing how the inclusion (or not) of these determinants on the COVID-19 pandemic epidemiological analysis manifests and contributes to the necropolitics and increases unjust and avoidable health inequities.
Thus, this article tried to fill this gap without exhausting the topic. It sought to highlight the importance of the racial variable in the epidemiological data analysis of COVID-19 infections in Brazil. We understand that this article\'s theme gravitates towards necropolitics and deals with racism (institutional and structural, primarily). In order to provide a better understanding of the object and the intended goal, we decided to make a brief explanation based on selected epistemological references about the aspects below.
“Some will die?” Necropolitics and the choice of who may live and who should die
The Cameroonian philosopher, theorist, and politician, Achille Mbembe, discusses how State’s policies of exclusion are based on the idea of an existing "social enemy." According to him, the State selects groups who are considered useful or disposable15. Achille Mbembe\'s concept of necropolitics can be understood as a paradigm of the division between social segments. It regulates – and regularizes – the State\'s power over lives. The State dictates who is allowed to live and who should die to guarantee the operation of the capitalistic war engine.15 In this sense, the sentence that relativizes the gravity of the COVID-19 pandemic, said by the president of the Federative Republic of Brazil, Jair Messias Bolsonaro, on March 27, 2020, is loaded with "necro biopower". It reveals a morbid and intentional16 policy implemented and executed by the State.
The necropolitics\' concept confirms the understanding that the State does not deal with different groups in the same way. It also confirms the understanding according to which the constitutional right to live will depend on the group that a person belongs to. The necropolitics\' concept is related to the State\'s measures that promote life and death based on characteristics that rank people, stratifying them among those who should be eliminated and those who may live.16 In a society founded on racism, which is one of the mechanisms of a domination political system, two complementary ideas define modern forms of subjugation and death18 (p.146): the supposed existence of both "races" and "inferior" human races18.
From this perspective, Bento19 says that death policies have characterized Brazil’s history. These are systematic techniques planned and enforced by the State against populations that must disappear20 (p.04).
The black population’s health and the silence of the notification forms: a brief contextualization
Historically neglected, the interface between racism and the black population\'s health has only recently become the object of Collective Health research.21 Wenerck10 considers that the lack of data related to race is a sign of how delicate this topic is both in the research fields and in health policies formulations.10
For instance, in epidemiology, race was not part of the discussions for a long time. It was not present in any official papers. It only began to be included in health information systems around the second half of the 20th century, due to black movement’s demands.10,22,23
Although there is a lack of epidemiological analysis on the topic, some studies on child mortality, deaths from external causes, risk of pregnancy and birth complications, and reduced access and accessibility to health services show that the black population\'s health conditions have worsened. Meanwhile, the quality of information on death causes of this population is being compromised.24 Buss and Pellegrini Filho25 recognize that inequities between people and groups of people in Brazil are strong and self-evident. Health inequities in this country, besides being systematic and relevant (p.02), are, above all, avoidable, unjust, and unnecessary25 (p.02).
Among several questions, one is particularly significant: organizations and black movement active participants believe that the applicability of race variables is legitimized because it demystifies the mythology of Brazil being a racial democracy. When we ignore this variable, we jeopardize the investigations of inequities in the Brazilian healthcare system.22 Although Brazil recognizes the relevance of this information for health policy evaluation, its inclusion in health information systems is new. In order to briefly examine the process that included black people’s well-being in health care programs concerning health policies, laws, guidelines and decrees,26-29 we created a timeline (Figure 1) of key milestones achieved due to the insertion of ethnic-racial information in the Brazilian health care system secondary data.
Insert Image 1.
As shown in Figure 1, both Decree 992, May 13, 2009 (which establishes the National Health Integrity of Black Population Policy, or PNSIPN) and Decree 344, February 1, 2017, recognize the importance of inserting race/color data in health forms. This information is vital to monitor and evaluate actions established in the Brazilian Statute of Racial Equality, assuring the Brazilian black population equal access to health care system. 26-29
According to the Brazilian Decree 344/2017, filling in the race/color field is mandatory. However, recent studies have shown that most of the health information system forms lack information about race/color24, 30, 31. During the COVID-19 pandemic, epidemiologic vigilance has become one of the foundations of public health policies. It turns data into action32 which makes such information not neutral (neither is its omission). Therefore, every data informed via official organisms may be only an interpretation made with individual intentions. Also, it is important to say that any research as this one that investigates official data and clarifies intentions, is essential for understanding this structure
As a consequence, it becomes clear that this research is nothing less than necessary.

Methodology
This article is a literature review based on document and scientific literature analysis. Our research question is: considering Brazil’s situation during the coronavirus pandemic, how does the absence of the social health determinant, race/color, in epidemiologic analysis highlight the necropolitical mechanism of racism as a producer of health inequities?
We analyzed June 16, 2020, monitoring panels and epidemiologic bulletins from all Brazilian federal states and the Federal District. These are official information available on the state’s Health Departments websites and on their virtual platforms created to monitor the pandemic. The analysis aimed at finding race/color determinants in these panels and bulletins.
We searched for epidemiologic bulletins in all Brazilian local government websites and the Federal District. We found twenty-seven epidemiologic bulletins until June 17, 2020. We read all the available documents, and we systematized the data we collected. We tried to identify which states used the social determinants related to race/color on at least one of the following analysis categories: confirmed COVID-19 cases; SARS victims hospitalized and later confirmed as COVID-19 cases; and COVID-19 as the cause of death.
To better understand the implications of this health social determinant during the COVID-19 pandemic in Brazil, we conducted a literature review on the Virtual Health Library (BVS), the Scientific Electronic Library Online (SciELO), and PubMed databases. Our search strategy used Health Science Descriptors (DeCs) associated with the boolean operators: “black people AND COVID-19”, “racism AND COVID-19”, “racism AND coronavirus infections.”
We looked for national and international studies (in Portuguese, English, and Spanish) that connected COVID-19 cases and the black population. We excluded replicated studies and studies that did not include the research object. Initially, we found a total of 102 publications. After applying the inclusion and exclusion criteria, we selected nine documents, Image 2, and after the analysis, we built a summary table. We collected the data between May and July 2020.
Insert Image 2.
Since the data we used was anonymous and available for the general public, according to Ordinance 466/2012 from the National Health Council, the research did not need approval from the Human Research Ethics Committee.

Results and discussion
We analyzed twenty-seven epidemiologic bulletins and monitoring panels on June 17, 2020. Only five (19%) of the twenty-six Brazilian states, and the Federal District, had the race/color variable in at least one of the analyzed categories (confirmed COVID-19 cases; SARS patients who were hospitalized and later confirmed as having COVID-19, and deaths from COVID-19). The five states were: Alagoas, Amapá, Paraná, Rio Grande do Norte, and Rio Grande do Sul (Image 3). We also analyzed nine articles (Table 1) that helped us understand the information we gathered from the epidemiologic bulletins.
Insert Image 3.
Insert Table 1.
In individual register sheets of hospitalized SARS cases and in all death certificates issued by the Ministry of Health, the race field is present. In recent years the filling and analysis of this variable have been encouraged in order to provide information that could be used to develop more equitable public policies32 against the COVID-19 and other diseases. However, there is still a lack of data related to race/color.7, 34, 35
The Indicator Panel of the Brazilian Unified Health System (SUS), released in 2016, recognizes the need to fill the race/color field in registration forms and health information systems. These data are important to develop indicators.33 Nevertheless, some researchers.30, 31, 36 have pointed out that in several health information systems in Brazil, this field has not been filled in.
Concerning COVID-19, the data collected in Brazil revealed that only five states disclosed information on race/color variables. These five states, however, did not disclose information on the three categories we chose to analyze. Goes et al.7 studies reported a similar situation in the USA. Only two of the United States fifty states (Kansas and Illinois) released race-related data.
In Brazil, the Technical Committee of Black People’s Health (CTSPN)33, created by the Statute of Racial Equality and by Ordinance 2.629/2014, wanted to include discussions regarding black people’s well-being in health surveys. However, the CTSPN distribution map shows that only eleven states, and the Federal District, have such a mechanism. Of the five states that disclosed race/color data, all had such a Committee, except for the state of Alagoas.
The data analyzed from the five Brazilian states showed that the COVID-19 transmission rate among black people is higher in four of them. The exception was the state of Rio Grande do Sul, where 83,2% of its population is self-declared white/caucasian37. Regarding mild COVID-19 cases, in the state of Pernambuco, 60,5% of patients were black (non-white) while in the state of Rio Grande do Norte, 39% of patients were black (non-white).
Alagoas and Pernambuco informed that 66,5% and 77,7%, respectively, of all confirmed SARS (from COVID-19) patients were black. In the state of Alagoas, 68% of the patients who died from COVID-19 were black, in Paraná, 66%, in Rio Grande do Norte, 37%, and in Rio Grande do Sul, 5% (Rio Grande do Sul is the only state where most deaths were among white/caucasian people).
Although required, healthcare professionals, in many cases, did not fill in the race/color field (22% in the states of Rio Grande do Norte and Alagoas; 28% in Rio Grande do Sul; and 62,2% in Pernambuco). We observed the same in data regarding deaths, which corroborates with what Laurencin and McClinton’s38 found in the state of Connecticut, USA, where the race/color field was not filled in 55% of the confirmed cases.
The production of statistical data that consider the race/color variable has been mandatory in Brazil for some time, and the challenges to collect these data, regarding race/color, are explicit. Milanezi39 points out that despite the existence of the item race/color in SUS forms and information systems, we still have to deal with the lack of data and the inefficiency of data crossing.
It is important to say that the high percentage of omissions regarding the race/color variable may jeopardize COVID-19 general analysis, especially in the state of Pernambuco, where omissions exceeded 60% of the total. Melo and Valongueiro40 highlight that these omissions may mask or distort important information, compromising the understanding of the disease’s real magnitude. They also hinder any planning of actions aimed at monitoring and preventing the disease.
According to Milanezi39, some professionals consciously refuse to fill in the race/color field even after they were told to do so in their training. They even discourage their co-workers to follow local protocols stating that this information is not relevant compared to others. According to these professionals, this is an inconvenient topic to discuss with a patient.
During this study, we observed that the Brazilian Ministry of Health, through the Center for Emergency Operations in Public Health, in the Special Epidemiological Bulletin No. 09 on COVID-19 in Brazil, presented information on the distribution of hospitalizations due to SARS and deaths from the new coronavirus infection by race/color.42 The omission of the social determinant, race/color, in the epidemiological health analysis may reveal an intention to make invisible those who are most affected by the epidemic. It reflects how the Brazilian government strategies to fight COVID-19 show total disregard for human life.
Thus, not only public policies that are directly related to healthcare have an impact on the protection of people\'s lives. Other government actions also end up being responsible for "those who live and those who die." In this sense, genocide - understood here as deliberate extermination – can take different forms. In Brazil, the conditions that subjugate black people create and reproduce a historical framework structured in unjust social, cultural, and economic processes28 (p. 5). Racism is at the center of these structures, widening the gap of vulnerabilities and allowing non-white people to experience unequal health realities 41.
In order to promote healthcare equity, PNSIPN28 recognizes the existence of racism, ethnic-racial inequalities and institutional racism as social health determinants28 (p. 18), Werneck10 highlights, though, that the PNSIPN policies have not been adequately implemented. When analyzing COVID-19 in the USA, Millet et al.42 highlight that in order to have a complete notion of the impact of this disease on black populations, a greater number of states must decide to disclose race/color data.
Several studies indicate that comorbidities such as Diabetes Mellitus, Arterial Hypertension, and other chronic health conditions are risk factors that can worsen Sars-CoV-2 infection. Data from National Health Research (PNS in Portuguese) show, for example, that regarding chronic diseases, there is a predominance of Arterial Hypertension (44,2%) and Diabetes Mellitus (12,7%) in non-white people when compared to white people (22,1% and 6,4% respectively). A prevalence that even exceeds the national numbers (21.4% and 6.2%, respectively)43. The same data were also verified by Price-Haywood et al.44, in a retrospective cohort with 3,626 patients with COVID-19 in Louisiana, USA.
In addition to the findings that indicate the prevalence of chronic diseases among non-white people, it is important to highlight that other factors contribute to the development of these pathologies. These factors are also more common among the black population, such as inadequate consumption of fruits and vegetables, and alcohol abuse45. These racial differences in the distribution of the diseases and risk factors should not be attributed solely to biological and/or behavioral differences related to race/color. Above all, as Laster Pirtle46 reminds us, they are consequences of the systemic racism that structure people\'s lives.
It is also important to highlight that Brazilian Public Defender Offices (Federal and locals), together with representative groups, filed different petitions to Court demanding government officials to fill in the race/color field in health forms and publicize them (Image 4). According to Laurencin e McClinton38, representative groups from the USA also filed similar petitions in American courts.
Insert Image 4.
Nidhi Subbaraman34 and Goes et al.7 say that in the USA, the Center for Disease Control and Prevention (CDC) also hid the number of deaths and people infected by race and ethnicity. According to Nidhi Subbaraman34 and Goes et al.7, these data only began to be released in late April after public protests from legislators, doctors, and civil rights groups.
The omission of race/color information (and other analysis variables such as gender) from epidemiological surveillance system forms endorses the necropolitical structure that makes black people\'s deaths invisible. The message is that their lives can be taken at any time without any accountability from the State. In practice, the policies that the Brazilian government creates to face the pandemic ignore the black population. These policies are a necropolitical mechanism of structural and institutionalized racism. In this sense, racism, as Mbembe47 highlights, is the engine of the necropolitical principle. It is, above all, a technology that focus on allowing the exercise of biopower, in other words, the right of death.19 In the economy of biopower, racism works as a regulator of the distribution of death and it also allows the murderous functions of the State. (p. 17)
This type of omission is a distinctive feature of racism. It only confirms the myths that Brazil is a racial democracy and a country characterized by cordiality. To omit race and color from health forms is an attempt to hide the reality set before society\'s eyes: racial inequalities base the decision of who must die. The Criminal System that incarcerates, the police violence that annihilates, the public health system that ignores the deaths of black people, these are all symptoms of widespread institutional racism. The necropolitics found fertile ground in Brazil.
Poteat et al.48 point out that concerning COVID-19, we are not at the same risk. Like many others, this is a racialized disease48 (p. 03). As in the USA, structural racism in Brazil is located at the beginning of a cycle that culminates in the State\'s neglect.
The idea that the same size fits all, in other words, that the adoption of equal measures for an unequal society puts the health of the most vulnerable at-risk (black people, homeless people, LGBTQI+ population, and incarcerated people)49. In this sense, the World Health Organization and the Panamerican Health Organization (OPAS) recommend that governments develop social participation environments and build strategic alliances with the most vulnerable ethnic groups, ensuring their participation in the development and elaboration of actions to fight COVID-19.35
It is important to highlight that this article has some limitations, mainly because of the lack of data related to the pandemic and the health of the black population. The incipient amount of studies2 related to the State\'s omission regarding such data and necropolitics also limited this study. Furthermore, the time elapsed between the collection of the data and their publication is so long that by the time they are read, they no longer represent reality.
Final Considerations
Most of the articles that were part of this review were qualitative studies published in public health journals, predominantly in the year 2020. The surveys that the authors2, 7 conducted are complementary and converge with the data found in the analysis of epidemiological bulletins that the Brazilian states disclosed. Preliminary analysis of epidemiological bulletins of the states that released race/color data already shows that the highest number of SARS hospitalizations and deaths by COVID-19 are of black people.
Racism and social inequalities are barriers to equal access to basic services. However, according to Singh50, the actions necessary to mitigate those problems, despite being well known, are not taken. It reveals the necropolitical character of power, which operates through the reversal between life and death.51
When the State omits race/color data, it denies basic and fundamental rights. This omission characterizes the racist and obscurantist structure that underpins policies against COVID-19 in Brazil. It also brings the necropolitics discussion to the center of the debate. Meanwhile, the pandemic is spreading, and the number of deaths is growing. These are deaths that have been silenced, trivialized, naturalized, and that have been happening with consent41 (p. 12).
Finally, race/color data is a valuable tool for developing racial inequality indicators during the pandemic. Access to tests has been a privilege (and not a right), and the numbers point to greater morbimortality in the black population.2, 7 Such data should be made available not only by epidemiological surveillance centers but also by public policymakers. At the same time, it is essential to develop quanti-qualitative studies seeking to deepen such analyses and broaden the understanding of necropolitical mechanisms in racial control, especially during the COVID-19 pandemic, a time of extreme vulnerability.

Collaborators
All authors contributed substantially in the design and planning of the study, in obtaining, analyzing and/or interpreting the data, as well as in the writing and/or critical review and approved the final version to be published.

Acknowledgements
We want to thank Luzimary Vieira Pereira for the sensitive reading of the preliminary version and for understanding the urgency and absence during the production of this work. We also thank Everton Oliveira for his outstanding work in the construction of the images. Translated by members of the Voluntary translation of informative materials related to COVID-19 project, offered by NUPEL / UFBA and supervised by professors M. Daniel Vasconcelos B. Oliveira, Dr. Feibriss Henrique Meneghelli Cassilhas, Dr. Lucielen Porfirio, and Dr. Monique Pfau. Translators: Daniel Vasconcelos B. Oliveira, Jessica de Jesus Costa Gama Soares, Nathália Borges Azevedo e Venicius Ferreira Alves. To the anonymous reviewers of Ciência & Saúde Coletiva magazine for their comments and suggestions.
References
1. Noronha K, Guedes G, Turra C, Andrade M, Botega L, Nogueira D,Calazans L, Servo L, Ferreira MF. Pandemia por COVID-19 no Brasil: análise da demanda e da oferta de leitos hospitalares e equipamentos de ventilação assistida segundo diferentes cenários. Cad. Saúde Pública [periódico na Internet]. 2020 Jul. [acessado 2020 Jun 14];36(6): [cerca de 9 p.].
2. Baqui P, Bica I, Marra V, Ercole A, van der Schaar M. Ethnic and regional variations in hospital mortality from COVID-19 in Brazil: a cross-sectional observational study. Lancet Glob Health [periódico na Internet]. 2020 Jul. [acessado 2020 Jun. 05];36(6): [cerca de 10 p.].
3. Bardi G, Bezzera W, Monzeli G, Pan L, Braga I, De Macedo M. Pandemia, desigualdade social e necropolítica no Brasil: reflexões a partir da terapia ocupacional social. Revista Interinstitucional Brasileira de Terapia Ocupacional. 2020; 4(3):496-508.
4. Instituto Brasileiro de Geografia e Estatística (IBGE). Síntese de indicadores sociais: uma análise das condições de vida da população brasileira. Rio de Janeiro: IBGE; 2018.
5. Biato SV, Oliveira APB. Racismo Institucional na Saúde. Revista de Serviço Social da
UNIGRANRIO. [periódico na Internet]. 2019 [acessado 2020 Jun. 03]; 1(3): 118-138.
6. Araújo DFMS, Santos WCS. Raça como elemento central da política de morte no Brasil: visitando os ensinamentos de Roberto Esposito e Achille Mbembe. Rev. Direito Práxis. [periódico na Internet]. 2019 Nov. [acessado 2020 Jun. 03];10(4): 3024-3055.
7. Goes EF, Ramos DO, Ferreira AJF. Desigualdades raciais em saúde e a pandemia da Covid-19. Trabalho, educação e saúde [periódico na internet]. 2020 Maio [acessado 2020 Jun 02]; 18 (3): e00278110.
8. Barata RB. Epidemiologia e políticas públicas. Rev. bras. epidemiol. [periódico na Internet]. 2013 Mar. [acessado 2020 Maio 29]; 16(1):3-17.
9. Defensorias pedem que coleta de dados da Covid contemple registro de raça e cor. Revista Consultor Jurídico. [site da Internet]. 2020 Jun 17 .[acessado 2020 Jun 26]. Disponível em: https://www.conjur.com.br/2020-jun-17/defensorias-pedem-dados-covid-contemplem-raca-cor
10. Werneck J. Racismo institucional e saúde da população negra. Saúde e Sociedade [periódico na Internet]. 2016 Set. [acessado 2020 Jun 02]; 25(3): 535-549.
11. Soares Filho A. O recorte étnico-racial nos Sistemas de Informações em Saúde do Brasil: potencialidades para a tomada de decisão. In: Batista L, Werneck J, Lopes F, organizadores. Saúde da população negra. Brasília, Distrito Federal: ABPN, 2012. p. 49-69.
12. Romero DE, Maia L, Muzy J. Tendência e desigualdade na completude da informação sobre raça/cor dos óbitos de idosos no Sistema de Informações sobre Mortalidade no Brasil, entre 2000 e 2015. Cad. Saúde Pública [periódico na Internet]. 2019 Nov. [acessado 2020 Jun 02]; 35(12):e00223218.
13. Kabad J, Bastos J, Santos R. Raça, cor e etnia em estudos epidemiológicos sobre populações brasileiras: revisão sistemática na base PubMed. Physis. [periódico na Internet] 2012 Jun. [acessado 2020 Jun 14] 22( 3 ): 895-918.
14. Buss P, Pellegrini F. Iniqüidades em saúde no Brasil, nossa mais grave doença: comentários sobre o documento de referência e os trabalhos da Comissão Nacional sobre Determinantes Sociais da Saúde. Cad. Saúde Pública. [periódico na Internet] 2006 Set. [acessado 2020 Jun 14];22(9): 2005-2008.
15. Mbembe A. Necropolitica: seguido de sobre el governo privado indirecto. Santa Cruz de Tenerife, Melusina; 2011.
16. Araújo M. O que necropolítica tem a ver com a pandemia e com falas de Bolsonaro. Uol [site na Internet], 2020 Abr 03 [acessado 2020 Jun 14];. Disponível em: https://tab.uol.com.br/noticias/redacao/2020/04/03/o-que-necropolitica-tem-a-ver-com-a-pandemia-e-com-falas-de-bolsonaro.htm?cmpid=copiaecola
17. Brito M. Não. Ele não está. 1ª ed. Paraná: Appris Editora; 2018.
18. Foucault M. Em defesa da sociedade: curso no Collège de France. 2ª ed.. São Paulo: Editora WMF Martins Fontes, 2010.
19. Bento B. Necrobiopoder: Quem pode habitar o Estado-nação?. Cadernos pagu. [periódico na Internet] 2018 Set. [acessado 2020 Jun 14]; (53): [cerca de 16 p.].
20. Ribeiro M, Moura R. Entre a biopolítica e o necropoder: O lucro durante a pandemia. Justificando, [site na Internet] 2020 Abr 09 [acessado 2020 Jun 14];. Disponível em:https://www.justificando.com/2020/04/09/entre-a-biopolitica-e-o-necropoder-o-lucro-durante-a-pandemia/
21. Lopes F. Para além da barreira dos números: desigualdades raciais e saúde. Caderno de Saúde Pública [periódico na Internet] 2005 Set. [acessado 2020 Jun 14]; 21(5): 1595-1601.
22. Adorno R, Alvarenga A, Vasconcellos M. Quesito cor no sistema de informação em saúde. Estud. Av [periódico na Internet] 2004 Mar [acessado 2020 Jun 04] 18(50): 119-123.
23. Brasil S, Trad L. O movimento negro na construção da Política Nacional de Saúde Integral da População Negra e sua relação com o Estado brasileiro. In: Batista L, Werneck J, Lopes F. Saúde da população negra. Brasília: ABPN, 2012. p. 70-97.
24. Araújo EM, Costa MCN, Hogan VK, Araújo TM, Dias AB, Oliveira LOA. A utilização da variável raça/cor em Saúde Pública: possibilidades e limites. Interface (Botucatu) [periódico na Internet] 2009 Dez [acessado 2020 Jun 04]; 13(31); 383-394.
25. Buss P, Pellegrini Filho A. A saúde e seus determinantes sociais. Physis [periódico na Internet] 2007 Mar [acessado 2020 Jun 04]; 17(1); 77-93.
26. Brasil. Lei nº 12.288, de 20 de julho de 2010. Diário Oficial da União, 2010; 20 jul.
27. Brasil. Racismo como determinante social de saúde. Secretaria de Políticas de Promoção da Igualdade Racial, Brasília, DF, 2011.
28. Brasil. Política Nacional de Saúde Integral da População Negra: uma política para o SUS. Ministério da saúde, 2. ed. Brasília, DF, 2015.
29. Brasil. Portaria nº 344 de 1° de fevereiro de 2017. Diário Oficial da República Federativa do Brasil, Brasília, DF, 2017.
30. Santos J, Dias F, Carvalho M, Pedrosa G, Caetano S, Souza E. Avaliação de completude da variável raça/cor nas notificações de violência, 2009 a 2017, Rio de Janeiro. Revista Saúde em Foco. [periódico na Internet]. 2020 [acessado 2020 Jun 11]. 5(1):49-57.
31. Lino R, Fonseca S, Kale P, Flores P, Pinheiro R, Coeli C. Tendência da incompletude das estatísticas vitais no período neonatal, estado do Rio de Janeiro, 1999-2014. Epidemiologia e Serviços de Saúde [periódico na Internet]. 2019 [acessado 2020 Jun 12]. 28(2). [cerca de 12 p.]. Disponível em: https://doi.org/10.5123/S1679-49742019000200014.
32. Temporao J. O enfrentamento do Brasil diante do risco de uma pandemia de influenza pelo vírus A (H1N1). Epidemiol. Serv. Saúde [periódico na Internet]. 2009 [acessado 2020 Jun 12].18(3): 201-204.
33. Brasil. Ministério da Saúde. Secretaria da Gestão Estratégica e Participativa. Painel dos Indicadores de Saúde nº 10. Temático Saúde da População Negra . Brasília. 2016.
34. Subbaraman N. How to address the coronavirus’s outsized toll on people of colour. Nature [periódico na Internet], 2020 May. [acessado 2020 Jun 16]. 581(7809): 366-367.
35. Del Pino S, Camacho A. Consideraciones relativas a los pueblos indígenas, afrodescendientes y otros grupos étnicos durante la pandemia de la COVID-19. Organização Pan-Americana de Saúde, 2020.
36. Braz R, Oliveira P, Reis A, Machado N. Avaliação da completude da variável raça/cor nos sistemas nacionais de informação em saúde para aferição da equidade étnico-racial em indicadores usados pelo Índice de Desempenho do Sistema Único de Saúde. Saúde debate [periódico na Internet]. 2013. [acessado 2020 Jun 16]. 37(99): 554-562.
37. Governo do Estado do Rio Grande do Sul. Boletim Epidemiológico Covid-19, Semana Epidemiológica 24 de 2020. Secretária da Saúde do Rio Grande do Sul, 2020. Disponível em: https://coronavirus-admin.rs.gov.br/upload/arquivos/202006/18134431-be-covid-19-coers-se-24-160620.pdf
38. Laurencin C, McClinton A. The COVID-19 Pandemic: a Call to Action to Identify and Address Racial and Ethnic Disparities. Journal of Racial and Ethnic Health Disparities. 2020; 7: p. 398–402.Disponível em: https://link.springer.com/article/10.1007/s40615-020-00756-0
39. Milanezi J. “Eu não vou parar por causa de uma raça”: a coleta da raça/cor no SUS. Blog DADOS [site da Internet], 2020 June [acessado 2020 Jul 07]. Disponível em: http://dados.iesp.uerj.br/coleta-da-raca-cor-no-sus/
40. Melo GBT, Valongueiro S. Incompletude dos registros de óbitos por causas externas no Sistema de Informações sobre Mortalidade sobre Mortalidade em Pernambuco, Brasil, 2000-2002 e 2008-2010. Epidemiol Serv. Saude. [periódico na Internet]. 2015 Dez [citado 2020 Jun 07]; 24(4): 651-660.
41. De Jesus V. Racializando o olhar (sociológico) sobre a saúde ambiental em saneamento da população negra: um contínuo colonial chamado racismo ambiental. Saude soc. [periódico na Internet]. 2020 Mai [acessado 2020 Jun 12]; 29 (2): [cerca de 15 p.]. Disponível em: https://doi.org/10.1590/s0104-12902020180519.
42. Millett GA, Jones AT, Benkeser D, Baral S, Mercer L, Beyrer C, Honermann B, Lankiewicz E, Mena L, Crowley JS, Sherwood J, Sullivan PS. Assessing Differential Impacts of COVID-19 on Black Communities. Ann Epidemiol [serial on the Internet].2020 May [cited 2020 Jun 14]; 382: [about 10 p.]. Available from: https:// doi:10.1016/j.annepidem.2020.05.003
43.Brasil. Ministério da Saúde. Indicadores de vigilância em saúde descritos segundo a variável raça/cor, Brasil. Boletim Epidemiológico. Brasília, 2017.
44. Price-Haywood EG, Burton J, Fort D, Seoane L. Hospitalization and Mortality among Black Patients and White Patients with Covid-19. N Engl J Med [serial on the Internet]. 2020 Jun [cited 2020 Jun 4]; 382(26): [about 10 p.]. Available from: https:// doi:10.1056/NEJMsa2011686
45. Brasil. Ministério da Saúde. Vigitel Brasil 2018 População Negra: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequência e estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas para população negra nas capitais dos 26 estados brasileiros e no Distrito Federal em 2018. Brasília: Ministério da Saúde; 2019.
46. Laster Pirtle WN. Racial Capitalism: A Fundamental Cause of Novel Coronavirus (COVID-19) Pandemic Inequities in the United States. Health Educ Behav [serial on the Internet]. 2020 apr [cited 2020 Jun 16]; 47 (4): [about 9 p.]. Available from: https://doi: 10.1177/1090198120922942
47. Mbembe A. Necropolítica. 1ª ed. São Paulo: N-1 Edições; 2018.
48. Poteat T, Millett G, Nelson LE, Beyrer C. Understanding COVID-19 Risks and Vulnerabilities among Black Communities in America: The Lethal Force of Syndemics. Ann Epidemiol [serial on the Internet]. 2020 May [cited 2020 Ago 7]; 47: [about 4 p.]. Available from: https:// doi:10.1016/j.annepidem.2020.05.004
49. Devakumar D, Shannon G, Bhopal SS, Abubakarcriar I. Racism and discrimination in COVID-19 responses. The Lancet. [serial on the Internet]. 2020 Apr [cited 2020 Jun 14] 395(10231):[about 1 p.]. Available from: https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)30753-4.pdf
50. Singh I, Chand K, Singh A, Kandadi R K. Time for a culture change: understanding and reducing risk, morbidity and mortality from COVID-19 in those of black and minority ethnicity. Br J Hosp Med [serial on the Internet].2020 May [cited 2020 Jun 7]; 81(5): [about 4 p.]. Available from: https://doi.org/10.12968/hmed.2020.0241
51. Lima F. Bio-necropolítica: diálogos entre Michel Foucault e Achille Mbembe. Arq Bras Psicol. [periódico na Internet]. 2018 Jan [citado 2020 Jun 14]; 70(n spe): 20-33.