Racial inequality, racial discrimination and obesity incidence in adults from the ELSA-Brasil cohort

Abstract

BackgroundThis study investigated whether self-reported race/skin colour and perceived racial discrimination predict higher obesity incidence after approximately 4-year follow-up of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We also investigated whether these associations are modified by educational level.MethodsFollowing exclusion of individuals defined as obese (body mass index ≥30 kg/m2) at baseline, associations between race/skin colour and obesity incidence between the first (2008–2010) and second (2012–2014) visits were investigated in 10 130 participants. Next, associations between perceived racial discrimination and obesity incidence among black (n=1532) and brown (n=2958) individuals were investigated separately. Racial discrimination (yes/no) was assessed using the Lifetime Major Event Scale. Logistic regression models adjusted for age, sex and research site were used. All analyses were stratified for educational level.ResultsObesity risk was higher in Blacks with high education compared with white individuals to the same education level (OR: 2.22; 95% CI 1.62 to 3.04) following adjustments. After adjustments, obesity incidence was higher among black individuals reporting racial discrimination compared with peers who did not report this experience, but only among the low education group (OR: 1.64; 95% CI 1.08 to 2.51). No statistical association with perceived discrimination was observed among brown individuals.ConclusionResults are congruent with findings from other studies reporting associations between racial inequality and obesity incidence and also suggest racial discrimination may be one of the mechanisms leading to such inequalities. Also, it supports the paradox theory by which education modify the association in distinct directions.

Towards the multileveled and processual conceptualisation of racialised individuals in biomedical research

“…Such a tendency, reinforced by other phenotypic processes and social inequalities, may produce a growing number of racialised individuals struggling with obesity (Duggan et al, 2020 ; Valdez & Deomampo, 2019 ; Williams, 2021 ). The high percentage of obese people in minority communities leads to the development of harmful stereotypes and their further social stigmatisation and racialisation (Dovidio et al, 2018 ; Machado et al, 2021 ; Sanders, 2019 ). The stigma resulting from high body mass can additionally induce hypertension and exacerbate the health problems of racialised individuals (Abel et al, 2021 ; Blascovich et al, 2001 ; Levy et al, 2008 ).…”

“…They also have a worse position in the labour market and often encounter microaggression (Manns-James et al, 2020;McCubbin & Antonio, 2012). Such stereotypes, which frequently apply to whole racialised groups (Dovidio et al, 2018;Machado et al, 2021;Sanders, 2019), deepen social and health disparities.…”

Intersectional Discrimination Index: Initial stages of cross-cultural adaptation to Brazilian Portuguese

“…Some of the most popular instruments are the Everyday Discrimination Scale (EDS) 8 , the Major Experiences of Discrimination Scale 8 and the Discrimination Experiences Scale 2,9 . With the Inventory of Racial Experiences 10 and the Explicit Discrimination Scale 11,12 , the EDS and the Major Experiences of Discrimination Scale are among the most frequently used in research conducted in Brazil [13][14][15][16][17][18] .…”

Etapas iniciais da adaptação transcultural do Intersectional Discrimination Index para o português do Brasil

“…Entre os instrumentos de maior popularidade, encontram-se a Escala de Discriminação Diária 8 , a Escala de Experiências Maiores com Discriminação 8 e a escala de Experiências de Discriminação 2,9 . Com o Inventário de Eventos Racistas 10 e a Escala de Discriminação Explícita 11,12 , a Escala de Discriminação Diária e a de Experiências de Discriminação estão entre as mais frequentemente empregadas nas pesquisas realizadas no Brasil [13][14][15][16][17][18] .…”