Opinion – Public Health: Health of the black population matters

In a recent editorial, the scientific journal Cadernos de Saúde Pública emphatically defended the use of racial lines in health research and publications. One of the reasons, he highlighted: because there are anti-racist implications.

The strong argument follows the path of other international publications in the area of ​​biomedical sciences, such as the Journal of the American Medical Association. The movement of these magazines is due to the fact that questions arose, on the part of denialists, about the pertinence of the concepts of race and racism in the analysis of health. This negationism, by the way, that spreads through several spheres of contemporary social life.

At least since the 1990s, research has consistently shown that race, in many societies, is an important social determinant of health. According to David R. Williams, professor of Public Health at Harvard and one of the pioneers in these investigations, racial inequalities in health prevail even when there are socioeconomic adjustments in income or education.

This means that, when comparing the health outcomes of people with the same level of income or education, there are disadvantages in the negative results for black or brown women. The findings of this predictor variable in many situations are solid.

In Brazil, black women are more at risk of suffering obstetric violence and maternal deaths reached 65% of them, according to data from Fiocruz, in 2018. A few years ago, the UN warned, based on official data, that, in Brazil, Blacks have more preventable health problems, such as mortality of newborns before six days of life, sexually transmitted infections, leprosy and tuberculosis, in addition to being more exposed to intentional violent death.

In the pandemic, a study by the Instituto Pólis showed that, in the city of São Paulo, despite being younger, the black population was proportionally more affected by the virus that affects the elderly more. That is, the number of expected deaths among black and brown people should be significantly lower than that observed in official records.

These unfavorable health data for the black population, in a way, are a mirror of those found in spaces of political and economic power. Despite being 56% of the Brazilian population, according to the most recent figures from the IBGE, black men and women in the Chamber of Deputies, elected in 2018, are only 24%. And this is also because there was an improvement in this aspect, with the representation of this group having been increased by 5% in relation to the 2014 election.

In the business world, less than 5% of black workers have a management or board position, not to mention the pay gap when compared to those in the same position. Structural and institutional racism in health concerns not only care and assistance, but also discrimination against black-skinned health professionals.

The start up AfroSaúde has reverberated an interesting and disconcerting question, which makes us reflect: despite being the majority of the population, how many black doctors do you know and by how many have you been assisted? It is widely known that in medical courses, blacks are a minority, despite small advances in recent years due to affirmative policies such as racial quotas.

In addition, those who follow the daily lives of black and black health professionals often hear reports of discrimination. On March 12, for example, rescuer Laura Cardoso, from SAMU, denounced that, when going to the care of a patient, a family member shouted when he saw her: “And now, is she black?”. To which another replied, “Okay, she’s wearing gloves.”

Despite the explicit discrimination and the hygienist character of the statements, the nurse performed the procedure and provided the necessary assistance. Resilient reports like this seem to be no exception among black health professionals.

Nevertheless, the most perverse, explicit and dramatic face of racial inequities in health is the violent death of black people, either at the hands of the state, as in the case of George Floyd, in the USA, who died suffocated by a white policeman and raised his head. debate that “black lives matter”, whether by the violence spread in the social fabric, as in the case of the death of the young Congolese Moïse Kabagambe, earlier this year, in Rio de Janeiro.

In addition to this more dramatic facet, racial inequalities in health occur in very subtle and veiled ways, as is typical of racism. It is necessary to know more about this reality and, for that, more research and production of knowledge are necessary in order to support better public policies.

And these researches, as suggested by the editorial of the journal Cadernos de Saúde Pública, should maintain and improve the racial approach. In this sense, the Institute of Studies for Health Policies (IEPS), in partnership with Instituto Çare, recently inaugurated a research position to dedicate itself to the topic, with the challenge of exploring the data made available by DataSus.

An initiative that seeks to add efforts to others, especially linked to movements and collectives of black women health workers, which, historically, have drawn attention to the problem and to the near absence of health policy for the black population. After all, black lives matter, the health of the black population matters.