Page 37 - IJPS-9-2

International Journal of
Population Studies COVID-19 and intersectionality in Brazil

Table 2. Multiple analyses of race, gender, and lack 4. Discussion
diagnostic testing, by level of education, in individuals
with SARS during the COVID‑19 pandemic in Brazil, 2020 The main findings of this study highlight the combined
(n=179,295) effects of gender and race on the likelihood of undergoing
diagnostic testing among individuals with SARS during the
Variables No diagnostic test COVID-19 pandemic. Even after controlling for clinical
aOR (95% CI)* p severity markers and access-related variables that could
Higher education influence the likelihood of receiving diagnostic testing, it
White males 1.0 was observed that black females and males had less access to
White females 1.18 (0.69 – 2.02) 0.533 diagnostic tests compared to white individuals. Furthermore,
Black males 3.59 (2.19 – 5.89) <0.001 the study identified a difference between black females and
males in terms of accessibility to diagnostic testing, which
Black females 2.61 (1.51 – 4.52) 0.001 varied based on their social class: black females with lower
Primary school levels of education had reduced access to diagnostic tests,
White males 1.0 whereas black males with higher levels of education faced
White females 0.90 (0.68 – 1.18) 0.451 even greater barriers to accessing diagnostic testing.
Black males 2.70 (2.18 – 3.34) <0.001 Recent studies have highlighted the significant
Black females 3.22 (2.59 – 4.00) 0.001 barriers that black males and females face when accessing
Secondary school essential healthcare services, particularly in preventive
White males 1.0 care (Chinn et al., 2021; Silva et al., 2020). These barriers
White females 1.15 (0.81 – 1.63) 0.423 have far-reaching implications for their overall quality
of life. Internationally, it is evident that institutional and
Black males 2.59 (1.93 – 3.48) <0.001 structural factors play a pivotal role in the perpetuation
Black females 2.20 (1.60 – 3.03) <0.001 of these disparities in healthcare access, encompassing
Not applicable systemic discrimination within healthcare institutions
White males 1.0 (Parker et al., 2017) and limited employment prospects
White females 1.54 (0.85 – 2.79) 0.149 within the affected population (Mullany et al., 2021).
Black males 2.48 (1.47 – 4.20) 0.001 A qualitative study has brought to light the lower
Black females 2.13 (1.22 – 3.72) 0.008 utilization of health-care services among male groups, even
Unknown among higher social classes, in Brazil. This can be attributed
White males 1.0 to two prevalent factors in Brazilian culture. Firstly, the fear
of job loss plays a significant role, as many jobs in Brazil,
White females 1.18 (0.99 – 1.42) 0.062 particularly for the black population, are often precarious.
Black males 2.09 (1.78 – 2.44) <0.001 The fear of losing employment dissuades individuals,
Black females 2.29 (1.95 – 2.70) <0.001 including those from higher socioeconomic backgrounds,
Note: *aOR: Odds ratio adjusted for all variables in the conceptual from seeking healthcare services due to potential negative
framework. consequences for their job security. Secondly, the influence
of a sexist culture further contributes to the understanding
stronger effect (aOR = 3.59; p < 0.001) compared to females of reduced access to healthcare services among men.
(aOR = 2.61; p = 0.010). This cultural phenomenon leads men, regardless of their

With respect to the category of “education unknown,” socioeconomic status, to downplay or ignore their health
where it was not possible to specify participants’ level of concerns. Seeking healthcare may be viewed as a sign
of weakness or vulnerability, leading to avoidance of
education, similarities in the magnitudes were observed preventive care and delays in seeking medical attention
in the bivariate analysis. Specifically, black females and (Gomes et al., 2007).
males, in that order, were less likely to undergo diagnostic
In the Brazilian context, health-care inequities persist
testing. Finally, similar behavior was observed with regard among black individuals, transcending social class
to “education records not applicable,” which corresponds boundaries (Silva et al., 2020). Notably, individuals from
to children under 7 years old. Once again, black males and higher socioeconomic backgrounds, including black
females were tested less frequently than white males. The males, tend to rely less on public healthcare services
likelihood ratio test yielded a Chi-square statistic of 34.99 compared to their counterparts from lower economic
with 12 degrees of freedom and a p < 0.001. strata (Souza Júnior et al., 2021). This observation offers

Volume 9 Issue 2 (2023) 31 https://doi.org/10.36922/ijps.0865