title: Does life-course socioeconomic position influence racial inequalities in the occurrence of uterine leiomyoma? Evidence from the Pró-Saúde Study.
abstract: We aimed to investigate whether life-course socioeconomic position mediates the association between skin color/race and occurrence of uterine leiomyomas. We analyzed 1,475 female civil servants with baseline data (1999-2001) of the Pró-Saúde Study in Rio de Janeiro State, Brazil. Life-course socioeconomic position was determined by parental education (early life socioeconomic position), participant education (socioeconomic position in early adulthood) and their combination (cumulative socioeconomic position). Gynecological/breast exams and health insurance status were considered markers of access to health care. Hazard ratios (HR) and 95% confidence intervals (95%CI) were estimated using Cox proportional hazards models. Compared with white women, black and parda ("brown") women had higher risk of reporting uterine leiomyomas, respectively HR: 1.6, 95%CI: 1.2-2.1; HR: 1.4, 95%CI: 0.8-2.5. Estimates were virtually identical in models including different variables related to life-course socioeconomic position. This study corroborated previous evidence of higher uterine leiomyomas risk in women with darker skin color, and further suggest that life-course socioeconomic position adversity does not influence this association.
authors.affiliation: Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.
authors.forename: Karine de Limas Irio
authors.initials: Kde L
authors.lastname: Boclin
authors.affiliation: Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Faerstein
authors.affiliation: Bloomberg School of Public Health, John Hopkins University, Baltimore, USA, Bloomberg School of Public Health, John Hopkins University, Baltimore, USA.
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006801:Humans; D007889:Leiomyoma / Q000453:epidemiology* / Q000208:ethnology; D008137:Longitudinal Studies; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D014594:Uterine Neoplasms / Q000453:epidemiology* / Q000208:ethnology; D044465:White People; D055815:Young Adult