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Objetivo Analisar o sobrepeso, obesidade e os fatores associados à saúde em afrodescendentes hipertensos residentes em uma comunidade quilombola. Métodos Trata-se de um estudo epidemiológico, censitário, de delineamento  transversal e debase comunitária, realizado com 303 residentes de uma comunidade quilombola. Resultados Os resultados com os 303 afrodescendentes hipertensos, em sua maioria mulheres, identificou os principais fatores de risco cardiovascular com destaque para a menopausa, histórico familiar de problemas cardiovasculares, sedentarismo e diabetes tipo 2. Observou-se diferenças significativas entre homens e mulheres nos níveis de colesterol total, hdl e ldl. Uma análise de regressão logística indicou que sexo feminino, e altos níveis de colesterol total estavam associados a um índice de massa corporal (imc) mais elevado. Essas descobertas fornecem insights importantes sobre os fatores de risco cardiovasculares em afrodescendentes hipertensos, destacando a importância da identificação precoce e manejo desses fatores para a prevenção de doenças cardiovasculares nessa população. Conclusões O contexto do estudo reforça a necessidade de estratégias preventivas e intervencionistas para combater o sobrepeso e a obesidade nas comunidades quilombolas. O conhecimento dos riscos cardiovasculares e fatores associados é essencial para a implementação de intervenções eficazes e contribui como uma ferramenta para direcionar ações de saúde e políticas sociais nas comunidades quilombolas e em outras populações vulneráveis. Objective To analyze overweight, obesity and factors associated with health in hypertensive Afro-descendants living in a quilombola community. Methods This is an epidemiological, census, cross-sectional, community-based study carried out with 303 residents of a quilombola community. Results The results with 303 hypertensive Afro-descendants, mostly women, identified the main cardiovascular risk factors with emphasis on menopause, family history of cardiovascular problems, sedentary lifestyle and type 2 diabetes. Significant differences were observed between men and women in the levels of total cholesterol, hdl and ldl. Logistic regression analysis indicated that female sex, and high levels of total cholesterol were associated with a higher body mass index (bmi). These findings provide important insights into cardiovascular risk factors in hypertensive African Americans, highlighting the importance of early identification and management of these factors for the prevention of cardiovascular disease in this population. Conclusions The context of the study reinforces the need for preventive and interventionist strategies to combat overweight and obesity in quilombola communities. Knowledge of cardiovascular risks and associated factors is essential for the implementation of effective interventions and contributes as a tool to direct health actions and social policies in quilombola communities and other vulnerable populations. Objetivo Analizar el sobrepeso, la obesidad y los factores asociados a la salud en afrodescendientes hipertensos residentes en una comunidad quilombola. Métodos Estudio epidemiológico, censal, transversal, de base comunitaria, realizado con 303 habitantes de una comunidad quilombola. Resultados Los resultados, con 303 afrodescendientes hipertensos, en su mayoría mujeres, identificaron los principales factores de riesgo cardiovascular con énfasis en la menopausia, antecedentes familiares de problemas cardiovasculares, sedentarismo y diabetes tipo 2. Se observaron diferencias significativas entre hombres y mujeres en los niveles de colesterol total, hdl y ldl. El análisis de regresión logística indicó que el sexo femenino y niveles altos de colesterol total se asociaron con un mayor índice de masa corporal (imc). Estos hallazgos brindan información importante sobre los factores de riesgo cardiovascular en los afroamericanos hipertensos, lo que destaca la importancia de la identificación y el manejo tempranos de estos factores para la prevención de la enfermedad cardiovascular en esta población. Conclusiones El contexto del estudio refuerza la necesidad de estrategias preventivas e intervencionistas para combatir el sobrepeso y la obesidad en comunidades quilombolas. El conocimiento de los riesgos cardiovasculares y los factores asociados es fundamental para la implementación de intervenciones efectivas y contribuye como herramienta para orientar las acciones de salud y las políticas sociales en las comunidades quilombolas y otras poblaciones vulnerables.

Abstract The article presents a perspective on the Brazilian scientific production on the health of the black population (SPN) published in scientific journals. We performed a rapid scoping review combined with thematic and bibliometric analysis. Our search included four indexed databases. We retrieved 519 studies in line with the thematic axes and strategic underlying themes of the Agenda of Research Priorities of the Ministry of Health and the guidelines of the National Policy for the Comprehensive Health of the Black Population. The data mainly returned quantitative studies published from 1969 to 2022. Sixty-five of the selected studies were explicitly about the black population and 54 about the quilombola population. The analysis of the most recurrent terms in the titles of the selected studies evidenced that epidemiological aspects and health and disease conditions prevailed. We observed limitations in the currently available indexing descriptors, which do not cover the most conceptually appropriate terminology. This paper consolidates knowledge about the SPN-related scientific production. It supports the discussion on a propositional priority research agenda to improve health policies for this population, overcome racism, and denounce rights violations. Resumo O artigo apresenta uma prospecção da produção científica brasileira sobre a saúde da população negra (SPN) publicada em periódicos científicos. Trata-se de uma revisão de escopo rápida, combinada com análise temática e bibliométrica. As buscas foram realizadas em quatro bases indexadas. Foram selecionados 519 trabalhos em consonância com os eixos temáticos e subtemas estratégicos da Agenda de Prioridades de Pesquisa do Ministério da Saúde e das diretrizes da Política Nacional de Saúde Integral da População Negra. Os dados mostraram estudos publicados entre 1969 e 2022, a maioria deles com abordagem quantitativa. Entre os selecionados, 65 foram especificamente sobre a população negra e 54 sobre a população quilombola. A análise dos termos mais recorrentes nos títulos dos trabalhos selecionados mostrou que prevaleceram aspectos epidemiológicos e condições de saúde e doença. Observou-se limitações nos descritores de indexação hoje disponíveis, que não abrangem a terminologia mais adequada conceitualmente. O artigo contribui para consolidar o conhecimento sobre a produção científica relacionada com a SPN, subsidiando também a discussão em torno de uma agenda prioritária propositiva para pesquisas com vistas a aprimorar as políticas de saúde para essa população, superar o racismo e denunciar as violações de direitos.

To evaluate the cultural tailoring methods used in type 2 diabetes (T2D), prevention and management interventions for populations of Black African ancestry and to examine their effectiveness on measures of glycaemia. Three databases were searched in October 2020; eligible studies used a randomised controlled trial (RCT) design to evaluate the effectiveness of culturally tailored lifestyle interventions compared with usual care for the prevention or management of T2D in adults of Black African ancestry. Cultural tailoring methods were evaluated using the Facilitator-Location-Language-Messaging (FiLLM) framework, whereby facilitator refers to delivery by individuals from the target community, language focuses on using native language or language appropriate to literacy levels, location refers to delivery in meaningful settings, and messaging is tailoring with relevant content and modes of delivery. Sixteen RCT were identified, all from USA. The mean age of participants was 55 years, majority female. Six of fifteen RCT reported significant improvements in glycated haemoglobin (HbA1c) at 6 and 8 months; one, in prediabetes, reported significantly improved fasting plasma glucose. Diabetes knowledge improvement (5/7 studies) was associated with HbA1c improvement. The majority tailored to location (12/16), facilitators (11/16), messaging (9/16) and language (6/16) domains of FiLLM. Those with ethnically matched facilitators and those which tailored to more than one domain showed the greatest HbA1C benefits. This evidence supports the effectiveness of culturally tailored lifestyle interventions for T2D management in populations of Black African ancestry, with further RCT needed to evaluate interventions for T2D prevention and for communities outside of the USA.

Conclusion: Prolonged percutaneous application of depigmentation products could alter metabolic and vascular functions, and consequently install cardiovascular risks. [...]we recommended ways to prevent of AD in the African population. [5] Studies[6] conducted in humans have shown that these vasculo-metabolic risk factors related to AD are often associated with alterations of vascular function. [...]it appears that the prolonged use of dermocorticoids could cause an oxidative stress state and thereby perturbs nitric oxide (NO) availability in the vascular endothelium, leading to vascular complications in patients with depigmentation. Blood samples were withdrawn from antecubital vein after an overnight fasting for at least 8 h. Blood was drawn into fluoride tubes (5 mL) for glucose measurement, heparin tubes (5 mL) for lipid measurement, citrate tube (5 mL) for plasma fibrinogen determination. Biochemical parameters such as plasma lipids (total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density-lipoprotein-cholesterol) and glycemia of our subjects were evaluated by the standard enzymatic method on fresh blood samples. SAP and DAP were used to calculate mean arterial pressure (MAP) as: MAP=(SBP+2·DBP)/3 Evaluation of Vascular Function Vascular function was studied by flow-mediated dilation (FMD) of the brachial artery measured with ultrasound according to guidelines. By rapid deflation of the cuff, reactive hyperemia was induced, and scanning was performed at 5, 30, 60, 90, and 120 s and 10 min after cuff deflation to obtain the FMD, expressed in percentage of the baseline diameter (% FMD). Because of limited technical (software) resources, we were not able to capture the diameter continuously. Prognostic role...

Abstract Institutional racism is prevalent in the health services in Brazil and is based on concrete power relations that subjugate, dominate and exclude blacks from having adequate access to health care and health institutions. This critical essay analyzes the importance of expanding the debate, and the production of knowledge about the health of the black population (HBP), focusing on two points: the role of the National Policy for the Integral Health of the Black Population (PNSIPN) and the importance of including the skin color item in the health information systems; and the need for a process of permanent training of professionals, including contents related to the understanding of racism as an element of the social determination of health/disease and heir effects. To demonstrate how structural and institutional racism have affected the black population, we bring also examples of the quilombola populations in the context of the Covid-19 pandemic in the country since 2020. It is concluded that the promotion of care, the reduction of inequities and the quality of health care need to undergo changes in several dimensions, such as the strengthening of the SUS, the daily fight against structural and institutional racism, among others. Resumo O racismo institucional impera nos serviços de saúde no Brasil, fundados em relações concretas de poder que subjugam, dominam e excluem negros/as do adequado acesso aos serviços e instituições de saúde. Este ensaio crítico analisa a importância da ampliação do debate e da produção do conhecimento sobre a saúde da população negra (SPN), focando dois pontos: o papel da Política Nacional de Saúde Integral da População Negra (PNSIPN) e a importância da inserção do quesito cor nos sistemas de informação em saúde; e a necessidade de um processo de formação permanente dos/as profissionais, inserindo conteúdos relacionados à compreensão do racismo como um dos elementos de determinação social de saúde/doença e seus efeitos. Para demonstrar como o racismo estrutural e institucional tem afetado a população negra, trazemos também exemplos das populações quilombolas no contexto da pandemia de COVID-19 no país a partir de 2020. Conclui-se que a promoção do cuidado, a redução das iniquidades e a qualidade da atenção à saúde precisam passar por mudanças em várias dimensões, como o fortalecimento do SUS e o combate cotidiano ao racismo estrutural e institucional.

15 years after its first democratic election, South Africa is in the midst of a profound health transition that is characterised by a quadruple burden of communicable, non-communicable, perinatal and maternal, and injury-related disorders. Non-communicable diseases are emerging in both rural and urban areas, most prominently in poor people living in urban settings, and are resulting in increasing pressure on acute and chronic health-care services. Major factors include demographic change leading to a rise in the proportion of people older than 60 years, despite the negative effect of HIV/AIDS on life expectancy. The burden of these diseases will probably increase as the roll-out of antiretroviral therapy takes effect and reduces mortality from HIV/AIDS. The scale of the challenge posed by the combined and growing burden of HIV/AIDS and non-communicable diseases demands an extraordinary response that South Africa is well able to provide. Concerted action is needed to strengthen the district-based primary health-care system, to integrate the care of chronic diseases and management of risk factors, to develop a national surveillance system, and to apply interventions of proven cost-effectiveness in the primary and secondary prevention of such diseases within populations and health services. We urge the launching of a national initiative to establish sites of service excellence in urban and rural settings throughout South Africa to trial, assess, and implement integrated care interventions for chronic infectious and non-communicable diseases.

Background Black people are disproportionately affected by structural and social determinants of health, resulting in greater risks of exposure to and deaths from COVID-19. Structural and social determinants of health feed vaccine hesitancy and worsen health disparities. Objective This scoping review explored interventions that have been employed to address vaccine hesitancy among Black population outside of African and Caribbean countries. This review provides several strategies for addressing this deep-rooted public health problem. Methods The scoping review followed the five-step framework outlined by Arksey and O’Malley. It complies with reporting guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Research studies that examined interventions utilized to promote vaccine confidence within Black populations living outside of African and Caribbean countries were reviewed. Findings A total of 20 articles met the inclusion criteria for this study: 17 were quantitative studies and three were mixed-method studies. This scoping review highlighted six themes: educational advancement, messaging, multi-component approaches, outreach efforts, enhancing healthcare access, and healthcare provider leadership. Conclusion The review identified effective interventions for addressing vaccine hesitancy among Black populations outside Africa and the Caribbean, emphasizing education, multidimensional approaches, and healthcare provider recommendations. It calls for more qualitative research and interventions in countries like Canada and the UK to enhance vaccine confidence and reduce mistrust.

Abstract Thirteen years after the publication of the National Policy for the Comprehensive Health of the Black Population (PNSIPN, Política Nacional da Saúde Integral da População Negra), filling out the race/skin color question in the patient identification form remains a challenge. Authors have focused on the need to integrate knowledge from the science of implementation into public policies. The aim of this article is to describe and analyze the implementation of the collection of the race/skin color item carried out by the professionals responsible for the registration of patients at a university hospital in the city of São Paulo. This was an exploratory and descriptive study, structured from three constructs of the Consolidated Framework for Implementation Research (CFIR): intervention, internal scenario and characteristics of individuals. Most records of race/skin color in the observed institution are made by heteroidentification. Based on the CFIR constructs, aspects identified as obstacles and facilitators are identified. The implementation of the collection of the race/skin color item by self-declaration, as provided for in the PNSIPN and in Ordinance n. 344/2017, is still incipient and depends mainly on organizational changes, which can favor its effectiveness. Resumo Após 13 anos da publicação da Política Nacional da Saúde Integral da População Negra (PNSIPN), o preenchimento do quesito raça/cor na identificação de pacientes permanece um desafio. Autores têm se debruçado sobre a necessidade de integrar os conhecimentos da ciência da implementação às políticas públicas. O objetivo deste artigo é descrever e analisar a implementação da coleta do quesito raça/cor feito pelos profissionais responsáveis pelo registro dos pacientes num hospital universitário do município de São Paulo. Estudo exploratório e descritivo, estruturado a partir de três constructos do Consolidated Framework for Implementation Research (CFIR): intervenção, cenário interno e características dos indivíduos. Resultados: a maioria dos registros do quesito raça/cor na instituição observada é feita por heteroidentificação. A partir dos constructos do CFIR, são identificados aspectos apontados como obstáculos ou facilitadores. A implementação da coleta do quesito raça/cor por autodeclaração, como previsto na PNSIPN e na Portaria 344/2017, ainda é incipiente e depende de mudanças, sobretudo organizacionais, que favoreçam sua efetivação.

Background: The COVID-19 pandemic further exposed the prevalence of existing health disparities in Black communities in the U.S. The current study evaluates COVID-19 data collected in Gary, Indiana, from June 2020 to June 2021. We hypothesized that the number of COVID-19 cases, hospitalizations, and deaths were influenced by race and income. Methods: In collaboration with the Gary Health Department (GHD), we analyzed demographic data on COVID-19-positive cases. Results: Compared to Gary’s non-Black population, age- and population-adjusted rates of hospitalizations and deaths in the Black population were 3-fold (p < 0.0001) and 2-fold (p < 0.05) higher, respectively. This is despite a higher infection rate (p < 0.0001) in the non-Black population. The median household income of a zip code was negatively correlated with COVID-19 hospitalizations (R2 = 0.6345, p = 0.03), but did not correlate with infections and deaths. Conclusions: The current study demonstrates clear health disparities of income and race in the context of COVID-19-related infections and outcomes in the city of Gary. Indiana University School of Medicine Northwest and GHD officials can collaborate to utilize these data for the reallocation of resources and health education efforts in Gary’s highly populated, low-income, and predominantly Black neighborhoods. It should also prompt further investigation into national health resource allocation.

The ongoing COVID-19 pandemic has emerged as an unprecedented challenge for healthcare systems across the world. To date, there has been little application of a race, migration and gender lens to explore the long-term health and social consequences of COVID-19 in African, Caribbean and Black (ACB) communities in Canada, who have been disproportionately impacted by this pandemic. The evidence presented in this commentary suggests that recovery strategies need to adopt an intersectional lens taking into account race, migration and gender since ACB women and ACB immigrant women have been among the populations most impacted both personally and economically. To do so, there is an urgent need to incorporate variables capturing race, beyond “visible minority” status; gender, beyond looking at differences between women and men; and factors to help understand the complexities of migration trajectories (i.e., beyond the dichotomy of born in Canada versus not born in Canada categories) in Canadian datasets. We provide examples of policy and practice initiatives that will be urgently required to address the needs of these population groups as these race-based data become available. La pandémie de COVID-19 en cours se révèle être un défi sans précédent pour les systèmes de santé du monde entier. Jusqu’à maintenant, on a très peu appliqué le prisme de la race, de la migration et du genre pour explorer les conséquences sociosanitaires à long terme de la COVID-19 dans les communautés africaines, caribéennes et noires (ACN) du Canada, qui ont été démesurément touchées par cette pandémie. Selon les données probantes présentées dans notre commentaire, les stratégies de rétablissement doivent adopter un prisme intersectionnel qui tient compte de la race, de la migration et du genre, car les femmes ACN et les immigrantes ACN sont parmi les populations les plus touchées, personnellement et économiquement. Pour cela, il faut de toute urgence intégrer dans les jeux de données canadiens des variables qui saisissent la race, au-delà du statut de « minorité visible »; le genre, au-delà des différences entre femmes et hommes; et les facteurs qui aident à comprendre les trajectoires de migration dans toute leur complexité (c.-à-d. au-delà de la dichotomie des catégories « né au Canada » et « né à l’étranger »). Nous donnons des exemples d’initiatives stratégiques et pratiques qui seront nécessaires à très court terme pour répondre aux besoins de ces segments démographiques à mesure que les données fondées sur la race deviendront disponibles.