Race, Color and Ethnicity in Epidemiologic Studies Carried Out with Brazilian Populations: Systematic Review on the PubMed Database

Objective: To analyze the use of the variables race, color and ethnicity in epidemiologic studies, carried out with Brazilian populations. Methods: This is a systematic review, conducted in the PubMed bibliographic database, on papers published between 2000 and July 2010. A data extraction form was used to obtain data from all individual studies, such as their objectives, the relevance of the racial/ethnic classification in their analyses, participants’ socio-demographic characteristics, including aspects related to the methods of racial classification, as well as the adherence to a set of recommendations on the use of race, color and ethnicity in biomedical publications. Results: After initially identifying 1,174 references, 151 were included in the review. Higher proportions of each of the following results were observed among papers in which the racial/ethnic classification was central to their analyses – of these, 18% justified the use of racial/ethnic categories, 16% regarded racial/ethnic classifications as context-dependent and fluid, 65% described the methods adopted for racial/ethnic classification, 17% took the racial/ethnic classification as a proxy for genetic variation, 26% considered such classification as a risk factor for health outcomes, 47% considered socio-economic factors in the interpretation of racial/ethnic inequalities in health and 27% adjusted these racial/ethnic disparities for socio-economic factors in their statistical models. Only two studies elucidated the concept underlying the use of race, color or ethnicity. Conclusions: Brazilian epidemiologic studies do not follow established criteria on the use of the racial/ethnic variable; this should be urgently improved in public health research.