Skin Colour, Perception of Racism and Depression among Adolescents in Urban Brazil

Abstract

Background: The relation between race, ethnicity and health has been recognised as having an important role in the understanding of social inequalities in health. In Brazil, miscegenation (the mixing of different ethnicities or races, especially in marriage) is recognised as a sign of racial tolerance, but individuals with black skin colour have poorer social and health indicators than whites. The hypothesis that perceived racial discrimination is associated with depression and depressive symptoms among adolescents living in a Brazilian urban area is analysed, taking into consideration sociodemographic variables, socioeconomic status and skin colour. Method: This paper presents results from a cross-sectional study carried out with a random one-stage cluster sampling of households in the city of Salvador, Bahia, Brazil. The study population comprises 973 individuals from 10 to 21 years of age who answered questionnaires about racial discrimination, sociodemographic and health-related variables. Major depression according to DSM-IV criteria was assessed using a validated Portuguese version of the Patient Health Questionnaire (PHQ). The overall prevalence of major depression was estimated as 10.4%. Results: No statistically significant differences were found for prevalence of major depression or any depressive symptom according to skin colour (Black versus non-Black). However, adolescents who reported racial discrimination were more likely to have major depression, even after adjustment for age, sex, socioeconomic status, skin colour and self-esteem (Adjusted Prevalence ratio ¼ 2.00, 95% Confidence Interval: 1.37-2.97). Low self-esteem was not associated with racial discrimination. Conclusion: Depression among adolescents is a common disorder. Skin colour, a biological component of ethnic differences, was not a factor associated with depression or depressive symptoms. Instead, the perception of racial discrimination was a strong potential risk factor for major depression in this population group, which needs to be addressed in further studies and considered in preventive and mental health care programs.

Factors associated with depression symptoms in high school students in São Paulo, Brazil

“…Depression was assessed using the Patient Health Questionnaire (PHQ) depression module developed by Spitzer et al 24 This questionnaire was translated and adapted to Portuguese by Santana et al 20 after evaluation of adequacy through back translation and reliability test of psychiatric diagnosis. Nine questions were used to assess depression symptoms as follows: "Over the past two weeks, how often have you:" a) had little interest or pleasure in doing things; b) felt down, depressed or without future; c) had sleeping problems, d) felt tired or having little energy; e) had loss of appetite or increased appetite; f) felt bad about yourself; g) had trouble concentrating, h) felt restless or being slowed; i) had thoughts of suicide.…”

Age, class and race discrimination: their interactions and associations with mental health among Brazilian university students

“…The previous Brazilian studies on the subject found that skin color/race discrimination was directly associated with depression 18,19 . However, given that the assessment instruments utilized in the studies inherently attributed discrimination to skin color/race, it was not possible to assess the association between distinct types of discrimination as well as their interactions in a research context outside the USA.…”

“…For instance, to the best of the authors' knowledge, there are only two published investigations on the mental health effects of discrimination in Brazil 18,19 . This country is often highlighted for the complexity and distinguishing aspects of its social relationships 20 , and has recently experienced a renewed interest in the social impacts of discrimination.…”

“…The work was also devised to expand upon preliminary Brazilian research on discrimination and mental health, which was limited to the exclusive assessment of racial discrimination 18,19 . Evaluation of multiple types of discrimination and their relations with health outcomes may shed light on different mechanisms by which discrimination harms health, clarify the relative importance of each type in distinct sociocultural contexts, and allow for the assessment of effective policies against, for example, homophobia, sexism, and racism.…”

Does the way I see you affect the way I see myself? Associations between interviewers' and interviewees' "color/race" in southern Brazil

“…Various studies in the health literature have grouped blacks and browns in a single category 28,29,30,31 . This procedure has generally been used as a justification to maintain high statistical power, since the two groups taken separately would constitute sparse strata.…”