Racial inequities deeply affect the health and development of children and adolescents, impacting socialization, self-perception and access to fundamental rights [1]. Collecting and analyzing data disaggregated by race is essential to understanding how racism manifests itself and generates inequities, allowing the creation of more just and effective public policies, capable of strengthening territories in the promotion of mental health.
Although there has been an effort for collecting racialized data for the construction of the Mental Health Promotion Index (IPSM), the limitations are evident. In many cases, information on race or color is not collected, is incomplete or is inconsistent in its coverage in different territories, which makes the precise analysis of indicators and the visualization of inequities difficult. The absence of these data in several contexts and for different indicators is also a manifestation of the non-prioritization of a central instrument for taking racial inequities and racism out of invisibility and substantiating the decision-making that will overcome them.
In Brazil, the National Policy of Comprehensive Health for the Black Population recognizes racism as a social determinant of health and emphasizes the need for improving the collection and analysis of these data [2]. However, great challenges are still faced with not only the availability and quality of this information, but also in the completeness and consistency of these data.
Prior studies have been identifying this important gap in the availability of racialized data in the country due to the incompleteness of the race/color field [3,4], despite the compulsory nature of its collection in various areas of public administration, including the health information systems and the School Census [5,6].
In the School Census, for example, despite its completion being compulsory, it is possible to fill in the field with “not declared”, which complicates the analysis and production of information disaggregated by race/color. In 2023, 20% of enrolled students did not have this information declared [7]. On the other hand, it is fundamental to highlight that sources of data on vital statistics in Brazil, specifically the Mortality Information System (SIM) and the Live Births Information System (SINASC), present high completeness (>97%) of the race/color field [4] and, therefore, the analysis and dissemination of racialized statistics becomes a matter of prioritization and political will.
To implement more effective interventions and strengthen mental health promotion in vulnerable territories, it is fundamental that data disaggregated by race are available and systematically collected and analyzed. This is not only a technical demand, but a matter of social justice, which requires the engagement of different actors, such as public administrators, health professionals, users and society. Without these data, any attempt at the promotion of equity will be limited and important social dynamics will be ignored. Only by overcoming these limitations will it be possible to face racial disparities and build health policies that adequately care for the population, with equity, justice and inclusivity, especially for historically marginalized groups.
Referências
1. Comitê Científico do Núcleo Ciência Pela Infância. Racismo, educação infantil e desenvolvimento na primeira infância. São Paulo: Fundação Maria Cecilia Souto Vidigal; 2021. Available: https://ncpi.org.br/wp-content/uploads/2024/08/Racismo-educacao-infantil-e-desenvolvimento-na-primeira-infancia.pdf
2. Brasil., Ministério da Saúde., Secretaria de Gestão Estratégica e Participativa., Departamento de Apoio à Gestão Participativa. Política Nacional de Saúde Integral da População Negra : uma política para o SUS. Brasília: MInistério da Saúde; 2013. Available: https://bvsms.saude.gov.br/bvs/publicacoes/politica_nacional_saude_integral_populacao.pdf
3. Souza IMD, Araújo EMD, Silva Filho AMD. Incomplete recording of race/colour in health information systems in Brazil: time trend, 2009-2018. Ciênc Saúde Coletiva. 2024;29: e05092023. doi:10.1590/1413-81232024293.05092023en
4. Coelho R, Remédios J, Nobre V, Mrejen M. O Quesito Raça/Cor no DataSUS: evolução e determinantes da completude. Instituto de Estudos para Políticas de Saúde; 2023 Jun. Available: https://ieps.org.br/nota-tecnica-30/
5. Brasil. Ministério da Saúde. Portaria no 344, de 1o de fevereiro de 2017. Dispõe sobre o preenchimento do quesito raça/cor nos formulários dos sistemas de informação em saúde. Ministério da Saúde; 2017.
6. Brasil. Ministério da Educação. Conselho Nacional de Educação. Câmara de Educação Básica. Resolução CNE/CEB no 1, de 15 de janeiro de 2018. Institui Diretrizes Operacionais para os procedimentos administrativos de registro de dados cadastrais de pessoa natural referentes aos estudantes e profissionais de educação que atuam em instituições públicas e privadas de ensino em todo o território nacional. 2018. Available: http://portal.mec.gov.br/index.php?option=com_docman&view=download&alias=80991-rceb001-18-pdf&category_slug=janeiro-2018-pdf&Itemid=30192
7. Agência Brasil. Um a cada quatro estudantes está sem raça declarada no Censo Escolar. 9 Nov 2024 [cited 19 Nov 2024]. Available: https://agenciabrasil.ebc.com.br/educacao/noticia/2024-11/um-cada-quatro-estudantes-estao-sem-raca-declarada-no-censo-escolar