Ethnic-racial disparities in poisoning cases: analysis of drugs of abuse, medicines and pesticides in Brazil

J Toxicol Environ Health A. 2024 Nov;87(21):863-878. doi: 10.1080/15287394.2024.2389413. Epub 2024 Aug 16.

Abstract

In Brazil, ethnic-racial inequalities exist in all fields, obstructing access to goods, services, and opportunities, including healthcare services. However, there are no apparent studies that assess, at a national level, ethnic-racial disparities in poisoning cases, emphasizing skin color as a determining factor. The study aimed to examine the relationship between race/ethnicity and general poisoning cases, by medications, pesticides, and drug of abuse in Brazilian states. Poisoning cases data were extracted for the years 2017, 2018, and 2019. Notification data for general poisoning cases and toxic agents were collected: medications, pesticides, and drugs of abuse. Data were categorized between whites and non-whites (blacks, browns, and indigenous) and without information on skin color/ethnicity. Rates of poisonings amongst ethnic-racial groups and cases of not declared skin color as well as relative risk (RR) of poisoning among non-whites were calculated. All states in the North, Northeast (states with the worst Human Development Index), Midwest, and 2 states in the Southeast exhibited higher rates of poisoning cases per 100,000 inhabitants among non-whites. The RR values for nonwhite individuals were higher in the North and Northeast regions for all types of poisonings. The type of poisoning cases that presented the highest RR for non-whites over the 3 years was drugs of abuse (2-2.44), when compared to other types of poisonings from pesticides (2-2.33) and medications (1.5-1.91). The spatial distribution of poisoning cases rates and RR of nonwhite population support public policies to reduce socioeconomic and environmental inequalities.

Keywords: Health; discrimination; drug poisoning; ethnicity; inequality; pesticides; skin color.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Ethnicity / statistics & numerical data
  • Female
  • Health Status Disparities
  • Humans
  • Male
  • Middle Aged
  • Pesticides* / poisoning
  • Pharmaceutical Preparations
  • Poisoning* / epidemiology
  • Racial Groups / statistics & numerical data
  • Substance-Related Disorders / epidemiology
  • Young Adult

Substances

  • Pesticides
  • Pharmaceutical Preparations