Study: Race/Color Functional Limitation Disparities in a "Racial Democracy": Findings Among Middle-Aged and Older Adults in Brazil (DOI: 10.1093/geronb/gbag002)
Health disparities between Afro-Brazilians and their white peers are most severe in midlife, not old age. Growing up under authoritarian rule put these groups at a greater disadvantage than older generations who experienced early life in more democratic governments.
A new University of Michigan study reveals that for many Black (preto) and Brown (pardo) Brazilians, difficulty with mobility, memory, vision and hearing is worse in their 50s than in their 80s.
Researchers argue against the claim that Brazil is a "racial democracy" by finding that growing up under the country's military regime is a notable health disadvantage, especially for its preto and pardo communities. Although the dictatorship ended decades ago, the study, published in Journal of Gerontology: Social Sciences, shows that its legacy continues to degrade the health of aging Brazilians today.
This current middle-aged demographic was the first to experience early life within Brazil's military dictatorship (1964-1985). During this era, "colorblind" social policies ignored deep-seated racial stratification, leaving marginalized communities with scant access to the education, nutrition and health care necessary for healthy aging.
"These findings speak to 'the long arm of childhood,' which argues that early-life conditions set the stage for health later in life, by showing how Black and Brown Brazilians that grew up during the military dictatorship now have especially high disability risk," said lead author Shane Burns, a postdoctoral fellow at the Population Studies Center at U-M's Institute for Social Research.
"The life course perspective emphasizes how social and environmental contexts shape health trajectories over time. Brazil's tumultuous and unique political history, combined with its rapidly aging population, makes it especially interesting to study the implications for public health."
Burns and colleague Philippa Clarke, an ISR researcher and professor of epidemiology, looked at data from about 9,000 Brazilians aged 50 and older who participated in the 2015-16 Brazilian Longitudinal Study of Aging. They analyzed racial differences in reported difficulty with mobility, memory, vision and hearing across four age groups: 50-59, 60-69, 70-79 and 80-plus.
The analysis took into account factors like demographics, childhood background, education, income, health issues, family relationships and where people lived.
"The results were somewhat surprising but understandable, given Brazil's unique history," Burns said. "One would anticipate that racial health disparities would be worse in older age groups, as society becomes more equal, but we see here that the youngest age group has the most racial disparities, and it's because of the hostile political context that they grew up in."
Distinct risks, tailored solutions
The study breaks new ground by distinguishing functional limitation risk factors between preto and pardo populations, finding that their disadvantages differ, indicating that Black and Brown Brazilians face unique systemic obstacles. This calls into question decades of public policy that often grouped all nonwhite citizens together.
Researchers also found differences in memory across racial groups and age brackets. Black, Brown and Indigenous Brazilians ages 50-59 were more likely to report problems with episodic memory than their white peers.
In the 60-69 and 70-79 age groups, memory was worse among Black and Brown respondents. By age 80 and older, only Brown respondents continued to have memory difficulties.
"Poor socioeconomic conditions in childhood account for disparities affecting Black Brazilians, while poorer infrastructure in less developed regions relates to disparities facing Brown Brazilians," Burns said. "Early-life conditions for Black people and place-based factors, like region and urban/rural residence, for Brown people are key drivers of their poorer health compared to their white peers".
"Improving childhood conditions, especially by addressing poverty and upgrading infrastructure in underserved regions, could help prevent these disparities. Additionally, expanding health and long-term care access for at-risk populations could provide a more responsive approach, especially for those with higher dementia risk."
