Race and sex disparities in the prevalence of multimorbidity due to chronic diseases: cross-sectional study, Brazil

Abstract

Abstract Objective: To examine disparities according to race/skin color and sex, and their intersectionality in the prevalence of multimorbidity among Brazilian adults. Methods: This was a cross-sectional study with adults participating in the 2019 National Health Survey. The database and dictionary of variables are available on the Brazilian Institute of Geography and Statistics website. Multimorbidity (yes/no) was defined as the simultaneous presence of two or more chronic conditions. Poisson regression with robust variance was used to investigate associations between race/skin color (White, Brown and Black), sex (male and female), race/skin color-sex intersectionality (White males, Brown males, Black males, White females, Brown females and Black females), and multimorbidity. Prevalence ratios (PR) and their 95% confidence intervals (95%CI) were obtained. The analyses were adjusted for age and schooling. Results: Among the 57,229 participants, prevalence of multimorbidity was 24.3%. Brown people (PR 0.92; 95%CI 0.87; 0.98) had lower prevalence compared to White people. Females showed a higher prevalence of multimorbidity compared to males (PR 1.62; 95%CI 1.53; 1.71). The intersectionality analysis indicated higher prevalence of multimorbidity among White women (PR 1.58; 95%CI 1.46; 1.72), Brown women (PR 1.48; 95%CI 1.36; 1.60) and Black women (PR 1.55; 95%CI 1.39; 1.72), compared to White men. Conclusion: The study identified lower prevalence of multimorbidity among Brown people, and higher prevalence among females. Intersectionality revealed that only females, regardless of race/skin color, had higher prevalence compared to White males. The findings highlighted disparities according to race/skin color and sex in the prevalence of multimorbidity among Brazilian adults.