Mortality by skin color/race and urbanity of Brazilian cities

Objective: The skin color/race and urbanity are structural determinants of health. The relationship between these variables produces structure of social stratification that defines inequalities in the experiences of life and death. Thus, this study describes the characteristics of the mortality indicators by skin color/race according level of urbanity and aggregation to the metropolitan region (MR) of 5565 cities in Brazil, controlling for gender and age.Design: Descriptive study which included the calculation of measures relating to 1,050,546 deaths in the year survey of 2010 by skin color/race White, Black, and Brown according to both sexes, for five age groups and three levels of urbanity of cities in Brazil that were aggregated or not to the MR in the year of study. The risk of death was estimated by calculating premature mortality rate (PMR) at 65 years of age, per 100,000 and age adjusted.Results: The structure of mortality by skin color/race Black and Brown reflects worse levels of health and excessive premature deaths, with worse situation for men. The Whites, especially women, tend to live longer and in better health than other racial groups. The age-adjusted PMR indicates distinct risk of death by skin color/race, this risk was higher in men than in women and in Blacks than in other racial groups of both sexes. There have been precarious levels of health in the urban space and the MR has intensified these inequalities.Conclusions: The research pointed out that the racial inequality in the mortality was characterized by interaction of race with other individual and contextual determinants of health. Those Blacks and Browns are the groups most vulnerable to the iniquities associated with occurrence of death, but these differences in the profile and the risk of death depend on the level of urbanity and aggregation MR of Brazilian cities in 2010.