Seminário Raça, Discriminação e Saúde - Rio de Janeiro - Agosto 12-14, 2015

Seminário “Raça, Discriminação e Saúde: Perspectivas Históricas e Contemporâneas” Seminário promovido através da parceria FIOCRUZ/ University of Michigan, Ann Arbor Local e data: Copacabana Mar Hotel – Salão Copacabana - Rio de Janeiro, 12 a 14 de agosto de 2015. Organizadores: Dora Chor, Alexandra Stern e Ricardo Ventura Santos Apoio: Fiocruz (através da Vice-Presidência de Ensino, Comunicação e Informação); University of Michigan/ Ann Arbor; e Fundação Carlos Chagas de Apoio à Pesquisa do Estado do Rio de Janeiro (FAPERJ).

Dia 12 de agosto 09:15-09:50 Café da manhã de boas vindas 10:00-11:00 Abertura 11:00-12:00 Conferência: Nisia Trindade Lima (FIOCRUZ) Tema: Raça e Saúde no Pensamento Social Brasileiro 12:00-14:00 - Almoço Mesa 1 14:00-16:30 Tema: Raça, Saúde e História: Temporalidades e Interfaces A história do pensamento racial no Ocidente é longa e complexa, com significativas continuidades e rupturas ao longo dos dois últimos séculos. Essa mesa aborda diferentes temporalidade e interfaces entre raça e saúde, com foco na segunda metade do XIX, na primeira do XX e também no recente contexto de debates sobre variabilidade biológica humana a partir da genômica. Coordenadora/ Debatedora: Alexandra Stern (UMICH) Apresentadores: Tania Pimenta (COC) Joel Howell (UMICH) TabitaHunemeier (UFRGS) Elena Calvo-Gonzalez (UFBA) 16:30 Coffe break 1

Dia 13 de agosto Mesa 2 9:00-12:00 Tema: A Profícua Produção de Identidades Sociais a partir de Raça na Contemporaneidade Essa mesa visa refletir sobre as múltiplas expressões da produção de identidades sociais a partir de raça, não somente pensada na interseccionalidade com gênero e classe, como também com perspectivas emergentes, exemplificada pelas análises de ancestralidade biológica através de novas tecnologias biológicas. Coordenador/ Debatedor: Antônio Sergio Guimarães (USP) Apresentadores: Sueann Caulfield (UMICH) LenyTrad (UFBA) Lia Schucman (USP) 12:00-13:00 Almoço Mesa 3 13:00-15:00 Tema: Pertencimento Racial e a Expressão de Desigualdades Sócio-Econômicas em Saúde Como bem conhecido a partir de estudos nos campos da história e ciências sociais, sistemas de classificação refletem visões de mundo. Com foco na comparação BrasilEUA, essa mesa reúne apresentações que discutem como a operacionalização do conceito de raça na saúde e em outras áreas se manifesta através de esquemas classificatórios que são histórica- e politicamente situados. Coordenador/ Debatedor: Ricardo Ventura Santos (FIOCRUZ) Apresentadores: João Luiz Bastos (UFSC) Sarah Burgard (UMICH) Jerônimo Muniz (UFMG) 15:00-15:20 Coffee break

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Mesa 4 15:30-18:00 Tema: Raça em Estudos Clínicos e Epidemiológicos: Perspectivas Críticas No Brasil, tem ocorrido um substancial aumento no volume de pesquisas nos mais diversos campos da saúde, com recorte clínico, epidemiológico e/ou genético, que lançam mão da variável raça. Essa mesa tem por objetivo refletir sobre os usos de raça, considerada como constructo social, e questionar a “naturalização” do conceito em investigações no campo da saúde e em áreas correlatas. Coordenadora/ Debatedora: DóraChor (FIOCRUZ) Apresentadores: Eduardo Tarazona (UFMG) Eduardo Faerstein (UERJ) Margareth Hicken (UMICH) Alexandre Pereira (USP)

Dia 14 de agosto Mesa 5 9:00-11:30 Tema: Nas entranhas: a questão da discriminação racial e socioeconômica nos serviços de saúde O tema da discriminação no acesso a serviços de saúde é central para as políticas públicas e somente muito recentemente vem recebendo atenção mais sistemática no Brasil. Com foco no SUS, essa mesa pretende abordar resultados de investigações voltadas para o tema da discriminação racial nos serviços de saúde, levando em consideração outras expressões das desigualdades sociais, em particular as de recorte sócio-econômico. Coordenadora/ Debatedora: Claudia Travassos (FIOCRUZ) Apresentadores: Maria do Carmo Leal (FIOCRUZ) Luis Eduardo Batista (USP) Sherman James (Emory University) INTERVALO 11:30-11:45

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Mesa 6 11:45-13:00 Tema: Perspectivas/ Sínteses A partir de diferentes campos do conhecimento (história, sociologia e saúde pública), serão apresentadas perspectivas de síntese acerca das discussões ocorridas durante o seminário. Alexandra Stern (UMICH) Antônio Sergio Guimarães (USP) Sherman James (Emory) DóraChor (FIOCRUZ) 13:15- Almoço de encerramento

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Seminário “Raça, Discriminação e Saúde: Perspectivas Históricas e Contemporâneas” Resumo das Apresentações Alexandre Pereira The association between chronic non-communicable diseases, race and genetic factors in Brazil: dissecting social disparities and biology in cardiovascular disease. Cardiovascular disease (CVD) is likely to remain a major public health concern for the foreseeable future. CVD rates are also disproportionately higher among certain groups, particularly individuals of African ancestry, resulting in substantial health disparities. Behavioral, and thus modifiable, risk factors for CVD, such as diet and exercise, have had a high level of penetrance into public awareness, yet this increased awareness has had little effect on CVD rates. Identification of additional, novel modifiable risk factors could therefore have a large public health impact. At the same time, the importance of biological and social factors varies from one population to another. There is a clear need for the exploration both on genome-wide and demographic scales of data from samples of ethnically diverse groups in order to build a more robust view of the biological and cultural determinants acting on chronic diseases in humans. This imperative may present itself more acutely in highly admixture populations, where both social and economic inequalities are overwhelming, but genetic ancestry is also blurring the limits of race and ethnicity as predictors of this disparity. In Brazil, the concepts of race/color and genetic ancestry are intermixed and the lack of a clear distinction between them does not help in establishing clear concepts and definitions in which this discussion can move forward. We will discuss the use of both genetic ancestry and race/color of two separate constructs that should, rather than create confusion, bring more information to the disparity model and add new dimensions to the discussion in admixed populations.

Eduardo Tarazona I will focus on the operational use of the term race in epidemiological studies (what you call 'naturalisation'), the relationships between biogeographic ancestry studies (population genetics) and the use of the term race, trying to discuss what ancestry studies actually tell us and what these studies do not tell us. I think most of the debate on the use of the term race come from confusion about these issues. Another point is when we confuse an epidemiological perspective with a clinical perspective. Elena Calvo-González Genetics and ‘racial’ difference in contemporary Brazil: Haemoglobinopathies, ‘whiteness’ and ‘admixture’ biomedical literature. The historical role of biomedicine in shaping and legitimising ideas of race in Brazil has long been documented. Much less discussed, however, is how contemporary 5

biomedicine helps recreate notions of race. In this article I explore some of the uses of race, and particularly whiteness, in current biomedical research, using as a case study articles published on the prevalence of haemoglobinopathies, including sickle cell anaemia and 𝛽-Thalassaemia. One can only properly understand how race features in these texts by pointing to the links between ideas about admixture and purity, existing historical discourses about difference and Nation, and new genetic knowledge. Jerônimo Oliveira Muniz Volatilidade racial e a construção de desigualdades O monitoramento de desigualdades raciais no Brasil é, aparentemente, simples. Basta escolher um indicador de desigualdade entre brancos, pretos e pardos e acompanhálo no tempo e no espaço. Esta estratégia, no entanto, pressupõe que as categorias raciais são consistentes e estáveis. Caso não sejam, a dinâmica da desigualdade também resultaria da reclassificação racial, e não apenas da variação distributiva de recursos entre os grupos prédefinidos. Este estudo discorre sobre os diferentes tipos de incerteza racial classificatória (contextual, temporal, taxonômica, amostral e geográfica) e ilustra, a partir de literatura prévia e de dados secundários nacionalmente representativos, o tamanho da volatilidade racial nestes diferentes âmbitos. Para ilustrar o impacto da incerteza classificatória sobre a construção de desigualdades mostramos que, apesar da incerteza taxonômica ser alta, o seu impacto sobre a desigualdade racial de renda é pequeno. O impacto das demais incertezas sobre a desigualdade, entretanto, ainda precisa ser investigado em agendas futuras. João Luiz Bastos Racial classification in Public Health: the ambiguity in question Even though racial ambiguity remains as a sociological feature of the Brazilian national society, being extensively investigated by national and international scholars from the field of Humanities and Social Sciences, such a distinctive characteristic has not been equally recognized or addressed among Public Health researchers from Brazil. Taking as a point of departure the assumption that racial ambiguity has a direct impact on the identification, scientific scrutiny and tackling of social inequalities in health, this presentation is subdivided into four different sections. Initially, the most important results of a systematic literature review on the use of racial, color, and ethnic categories in 151 epidemiologic studies with Brazilian populations, published between 2000 and 2010, are discussed. The review shows the extent to which researchers working, directly or indirectly, with color, race or ethnicity among Brazilian populations endorse a set of seven established recommendations on the use of these concepts in biomedical publications. By showing that these recommendations are rarely followed in Brazilian epidemiologic research (the recommendation most frequently endorsed – in 52.3% of the reviewed papers – highlights the need to describe the methods adopted during racial classification), this section of the presentation sets the context of the scientific output under analysis. Next, the second and third parts of the presentation emphasize the main findings of two studies in which the lecturer was the lead author, exploring racial ambiguity in a city in the extreme South of Brazil, Pelotas (~350.000 inhabitants). Each of the two investigations was carried out with more than 3,000 participants, who were visited at their households to take part in a face-toface interview, and to be classified according to the five racial/ethnic categories (white, brown, black, yellow, and indigenous) used in the Brazilian national censuses, since the 6

1990s. The first Pelotas study focuses on the magnitude of socio-economic inequalities as a function of self-classified or interviewer-classified race. By demonstrating greater socioeconomic inequalities when interviewer-classified race is used, I contend that interviewerclassified race tends, more often than self-classified race, to remain associated with health outcomes whose relationship with socio-economic factors is strong, even after taking covariates into account. The second Pelotas study, unparalleled by previous Brazilian quantitative research on the topic, investigates the association between interviewers’ and participants’ self-classified race, as well as the influence of age, and gender on the process of racial attribution. The study reveals that male interviewees over 40 years of age were more likely to self-classify in a race category one degree lighter (white or brown, relatively to black) than the one chosen by their somewhat younger female interviewers. The analysis thus shows that gender, age and physical appearance all play a part in the process of racial classification commonly seen in health surveys. The fourth presentation section offers preliminary findings of a study on racial classification based on data from the 2010 Brazilian census, with special emphasis on the effect of age on the likelihood of self-classifying as white, brown or black among children under 15 years of age, born to the household head and his/her spouse. The initial findings indicate that the likelihood of self-classifying as white declines with increasing age, whereas the opposite is observed in terms of being classified as brown or black. In other words, individuals shift to darker racial categories (brown or black, relatively to white) as they grow up. Expanding upon the studies conducted in Pelotas, this preliminary analysis approaches racial ambiguity from a national perspective, while also further developing the study of a factor still scarcely explored in the process of racial classification, that is, age. The presentation finishes with remarks on the need to address racial ambiguity in Brazilian Public Health as a means to: (1) combat outdated notions of biological race, still prevalent in the field; (2) analyse and estimate the magnitude of social inequalities in health, including racial health differentials; and (3) reframe public policy and actions dealing with social determinants of health. Joel D. Howell From 1932-1972 the United States Public Health Service carried out a “natural experiment” in and around Tuskegee, Alabama, to study the natural history of untreated syphilis in the male negro. Those experiments have become the center of intensive discussions that long ago transcended the historical record of the experiments themselves. The attention paid to these experiments led directly to the 1974 National Research Act and the creation of institutional review boards, a regulatory device for all human subjects research using federal funds that is now ubiquitous in US biomedical research. In this presentation we will explore the idea of “race” as made manifest in the long history of the “Tuskegee” experiments. The paper is based on primary documents, secondary sources, and discussions with relatives of people involved in the experiments. We will start by examining the experiment’s original scientific and social rationale and attempting to understand that rationale as expressed in the 1930s. Some of the ideas originated with recent biomedical research on the existence of inherited characteristics, others with the possible role of race in defining disease characteristics. The spirochete believed to cause syphilis had only recently been discovered. It was known to have a predilection for damaging specific parts of the human body, especially the cardiovascular system and the central nervous system. For reasons having a great deal to with racial stereotypes, scientists hypothesized that spirochetes might travel throughout the body in different geographical patterns in members of different races, and that this pathogenic 7

organism might disseminate in distinctive ways in “Negro” men. Social and biological ideas about race were thus interrelated in the original experimental model. We will also interrogate the decision to situate the experiments in and around a rural southern town. We will consider the active participation of health professionals in the experiments, especially those associated with the Tuskegee Institute. In trying to understand how both the experimenters and study participants were characterized we will consider the respectability of the institution as well as the interaction of race with class. Rather than being a series of secret experiments, the investigators’ results were almost from the outset widely and prominently published, and their specific quantitative findings were regularly revised. We will ask about the decisions made by experimenters over the long course of the experiments in response to events such as the Second World War and subsequent ethical codes of conduct, changing medical therapies, and the US Civil Rights movement. Finally, we will explore the implications of the experiments for current behavior in the United States and for contemporary thinking about race and health care among patients, health care professionals, and medical researchers seeking to explore biological phenomena. As Susan Reverby and others have pointed out, the name “Tuskegee” has come to be used for a wide range of racially-defined events and issues. At times it has been used in ways that evoke “race” in simplistic biological terms that may impede both understanding and policy devoted to addressing racial disparities. Leny Trad Sentidos e intencionalidades na interface entre Identidade e Raça - para falar de identidade racial na Contemporaneidade Nesta comunicação pretendo distinguir e problematizar diferentes usos e aplicações do conceito de identidade, particularmente, na sua imbricação com raça ou etnia. Cabe salientar de imediato que, embora muitos sentidos ou concepções em voga tendam a realçar enfoques construtivistas e convergir na crítica a visões essencialistas, advogando o caráter descentrado, contraditório, móvel (termos recorrentes em Hall, 2000, 2009) ou polimorfa e bulímica (Dubar, 2009) das identidades sociais na contemporaneidade, não raro, tais proposições ou, principalmente, sua reverberação adquire contornos bastante ambíguos. Tais ambiguidades refletem em grande medida filiações e pertencimentos étnicos, ideológicos e políticos dos muitos atores sociais que transitam entre as diferentes esferas da narrativa pública e, sobretudo, as finalidades e contextos de socialização de ditas narrativas. Ao refletir acerca das imbricações entre sentidos e intencionalidades que permeiam as narrativas científicas sobre identidade e raça na contemporaneidade, resgato e atualizo a tipificação esboçada por Brubaker e Cooper (2000: Beyond Identity), que compreende cinco diferentes usos do conceito de identidade. A saber: 1) como fundamento ou base da ação social ou política; "identidade" se expressa aqui em oposição a "interesse" visando realçar modos não-instrumentais de ação; 2) para denotar uma igualdade fundamental e consequente entre os membros de um grupo ou categoria (gênero, raça, etnia, nacionalidade etc.); neste uso, a "identidade" desliza entre categoria de análise e categoria de prática; 3) para remarcar a "individualidade" como condição fundamental do ser social. "identidade" correspondendo a algo supostamente profundo, básico, permanente (enfoques psicológicos); 4) para destacar processos interativos, vinculados à solidariedade e à ação coletiva; "identidade" é entendida tanto como um produto contingente da ação social ou política, quanto como propulsora de mais ação; 5) para destacar a flutuação e a natureza instável, múltipla e fragmentada do "eu" contemporâneo (concepções pós-estruturalistas, pós-modernas, de influência foucaultiana). 8

Lia Vainer Schucman O lugar do branco nas relações raciais brasileiras O objetivo desta comunicação é discutir como a ideia de raça construída ao longo do século XIX ainda é apropriada e constrói sentidos e significados na produção de identidades raciais brancas na contemporaneidade brasileira. Este olhar sobre a categoria racial branca nos estudos de relações raciais se insere no que foi chamado nos Estados Unidos de estudos críticos sobre a branquitude (critical whiteness studies). Partindo do pressuposto que a categoria raça é necessariamente relacional, os estudos da branquitude passam também a estudar e colocar o branco em questão, retirando assim o negro do foco problemático no qual recaem os estudos sobre as desigualdades de raça. A lógica aqui segue duas formulações: a primeira, é tirar o olhar das identidades consideradas de margem e voltar para a autoconstrução do centro com o intuito de olhar, revelar e denunciar também o seu conteúdo, que até então tem sido privado de uma análise crítica, pois olhar apenas para os grupos minoritários contribuí com a ideia de norma dos grupos hegemônicos, ou seja, olhar apenas para o negro nos estudos de relações raciais ajuda a contribuir com a ideia de um branco em que a identidade racial é a norma. A segunda é pensar que se podemos admitir a problemática pós colonial brasileira para os negros é porque estamos todos inseridos em uma sociedade pós colonial, logo não podemos localizar apenas um estrato da sociedade nesta posição. Assim, se os negros brasileiros são pós-coloniais os brancos também o são. Com o propósito de pensar o branco nesta relação apresentarei neste simpósio os resultados de minha pesquisa de doutorado e com continuidade atualmente no pós doutorado onde procuro perguntar: quais os significados da branquitude na cultura brasileira? De que forma ela se caracteriza? Quais as identificações, semelhanças e diferenças nas formas em que os sujeitos brancos se relacionam com a branquitude? Quais os processos em que a raça opera na constituição dos sujeitos como brancos? E como a própria ideia de raça e os valores da branquitude diferenciam e hierarquizam internamente o grupo de brancos em nossa sociedade? A questão é entender como pressupostos falsos ou imaginários sobre a raça – quando esta, do ponto de vista biológico, não existe – passam a ter efeitos concretos tão poderosos na regulação das práticas cotidianas, percepções, comportamentos e desigualdades entre diferentes grupos humanos. Para a realização deste trabalho realizei entrevistas e conversas informais com 40 sujeitos paulistanos que se auto identificaram como brancos, sendo eles de diferentes classes sociais, idade e sexo. As análises demonstraram que há por parte destes sujeitos a insistência em discursos biológicos e culturais hierárquicos do branco sob outras construções racializadas, e, portanto, o racismo e a ideia de raça construída pelos “homens da ciência” ainda faz parte de um dos traços unificadores da identidade racial branca. Percebemos também que os significados construídos sobre a branquitude exercem poder sobre o próprio grupo de indivíduos brancos, marcando diferenças e hierarquias internas. Assim, a branquitude desloca-se dentro das diferenças de origem, regionalidade, gênero, fenótipo e classe, o que demonstra que a categoria branco é uma questão internamente controversa e que alguns tipos de branquitude são marcadores de hierarquias da própria categoria. Assim, para definir o que é branquitude e quem são os sujeitos que ocupam lugares sociais e subjetivos da branquitude é preciso pensar que as categorias sociológicas de etnia, cor, cultura e raça se entrecruzam, se colam e se descolam umas das outras, dependendo do país, região, história, interesses políticos e época em que estamos investigando. Ser branco e ocupar o lugar simbólico de branquitude não é algo estabelecido por questões apenas 9

fenotípicas, mas sobretudo por posições e lugares sociais que os sujeitos ocupam. Portanto, a branquitude precisa ser considerada “como a posição do sujeito, surgida na confluência de eventos históricos e políticos determináveis” (Steyn, 2004, p. 121). Neste sentido este trabalho situa-se dentro do campo de estudos pós coloniais sobre branquitude, que têm como objetivo central colocar o branco em questão com a perspectiva de compreender como o racismo construído pela idéia de raça do século XIX ainda faz efeito e produz identidades raciais brancas. A branquitude é entendida aqui como uma posição em que sujeitos que ocupam este lugar foram sistematicamente privilegiados no que diz respeito ao acesso a recursos materiais e simbólicos, gerados inicialmente pelo colonialismo e pelo imperialismo, e que se mantêm e são preservados na contemporaneidade. Luis Eduardo Batista Nas entranhas: a questão da discriminação racial e socioeconômica nos serviços de saúde O acesso e a qualidade da atenção em saúde é o tema que pretendemos abordar nessa mesa. Serão apresentados relatos de sondagem de opinião sobre a existência de racismo nos serviços de saúde. Para isso, será apresentado resultados de um estudo e de uma proposta de intervenção. Os resultados evidenciam que a população negra vem sendo discriminada nas unidades de saúde, como usuários e como profissionais. Os dados sugerem que os serviços de saúde, por meio de seus profissionais, aumentam a vulnerabilidade desses grupos populacionais, ampliando barreiras ao acesso, diminuindo a possibilidade de diálogo e provocando o afastamento de usuários. Diante do encontrado, acredita-se ser importante estimular discussões sobre o tema e desenvolver estudos que além de dar visibilidade às iniqüidades possam contribuir para a compreensão de como as discriminações atuam na saúde da população negra. Nessa apresentação também relatarei resultados do estudo da assistência entre puérperas. Pois, encontramos diferenças desfavoráveis às pretas e pardas quanto à escolaridade, à renda, e ao trabalho remunerado; as brancas tinham mais planos privados, e maior idade. As pretas e pardas tiveram menor número de consultas, menos ultrassonografias, mais cuidado pré-natal considerado inadequado, maior paridade, e mais síndromes hipertensivas. No parto, tiveram menos acompanhantes, mais partos vaginais, embora a cesárea tenha crescido o dobro entre as negras. Com mais frequência entraram em trabalho de parto e filhos nascidos de termo pleno (>39 semanas). Ainda que importantes disparidades persistam, houve alguma redução das diferenças sociodemográficas, e um aumento do acesso, tanto a intervenções adequadas quanto às desnecessárias e potencialmente danosas a sua saúde. Numa segunda etapa, pretendemos relatar resultados do projeto “Humanização do parto e nascimento: questões étnico/racial e de gênero”, proposta de ação/intervenção desenvolvido pelo Comitê Técnico de Saúde da População Negra da Secretaria de Estado da Saúde de São Paulo, realizado no Hospital Geral de São Mateus (HGSM). E que teve como proposta sensibilizar a equipe do hospital para os temas mortalidade materna em mulheres negras; discutir o impacto do racismo na saúde. E que resultou na inserção do quesito cor no sistema de informação hospitalar (Autorização de Informação Hospitalar), profissionais treinados para a questão da atenção a saúde da mulher; houve uma mudança de percepção da equipe da maternidade em relação a presença do Pai na hora do nascimento, Pai não é visita. Respeito a religiosidade – com a discussão do respeito a religiosidade e Estado laico, o paciente passou a definir se quer ou não receber visita de religioso e de qual credo. Os religiosos que frequentam o HGSM definiram que a capela passaria a ser um espaço inter-religioso. 10

Não menos significativa também é a constatação das desigualdades raciais presentes nas instituições e configuradas pelas relações de poder historicamente determinadas. Margaret Hicken There has been a growing, although contested, interest in documenting racial variation in health in Brazil. While research sugests that Blacks experience poorer health compared to Whites, the evidence is not conclusive. Moreover, empirical studies suggest that there may not be racial health differences between the two largest racial groups, Browns and Whites. The equivocal nature of this literature likely stems from racial group categories that are examined without reference to the social science literature on the social, economic, and political meaning of these group designations. Indeed, sociologists argue that both the meaning of “race” and the categories that comprise this construct are fluid across time and location in Brazil as well as across the age, socioeconomic status (SES) and gender of the individual, overlapping in meaning with “ancestry”, “color”, and “ethnicity” (the combination of which I will, from here, refer to as RACE – race/ancestry/color/ethnicity). In order to better capture the underlying determinants that drive population variation in health and disease distribution by RACE measures, we first must critically document and analyze how RACE measures have been used in the public health literature (both clinical and epidemiologic studies) and how these measures are related to health over time and location. By systematically documenting study measures and results over time and location, we can then descriptively analyze the study results against the contemporaneous meanings of the RACE measures derived from the social sciences. This social science literature places the meanings of the RACE measures in Brazilian sociohistorical spatial (e.g., urban/rural, north/south, etc) and temporal (e.g., post-affirmative action legislation, etc) context. Not only will this clarify why we see or don’t see racial variation in the extant public health literature, but, in combination with the social science literature, these comparisons will provide clues about the most appropriate measures to capture the social, economic, and political inequalities that are reflected through the population distribution of disease. The overall goal of this critical review and commentary is to clarify which RACE measures best capture inequalities in the social, economic, and political constraints and resources that are important for health and disease. I outline three major objectives to address this goal. First, I document the number of population-level empirical studies, reported in either Portuguese or English from 1970 to 2015, that report health outcomes by some RACE measure. The search for empirical papers is as follows: (1) any of the English RACE terms (“race”, “ancestry”, “color”, or “ethnicity”) in either the title or abstract and “Brazil” in the title is used when searching in PubMed; (2) any of the English RACE terms or “social”, “Brazil”, and “health” in the title is used when searching in Google Scholar; (3) any of the Portuguese RACE terms (“raça”, “ascendencia”, “cor”, or “etnicidade”) in the title or abstract and “Brasil” in the title is used for the Latin American and Caribbean Literature in Health Sciences (LILACS) and Scientific Electronic Library Online (SciELO) databases. These searches yield hundreds of potential studies for inclusion in this critical review and I use the following criteria for final inclusion. The paper must report: (1) on an original empirical study in Brazil; and (2) health outcomes (but not health service use outcome) by at least one of the RACE measures unadjusted and after adjustment for covariates.To improve comparisons over time and by region, I will further narrow the study of only certain health outcomes that have been examined to a relatively greater extent than others and that also reflect different social processes: (1) Infant health; and (2) chronic diseases (diabetes, obesity, cardiovascular disease). While bothoutcome categories capture different aspects of long-term social, economic, and political processes, infant health also 11

captures short-term processes and changes and is considered to mark a society’s investments in its population, particularly its most vulnerable segments. Second, I document and descriptively analyze specific aspects of these papers stratified by each health outcome. The year and location of data collection are recorded, as sociological evidence indicates that the use of RACE categories has changed over time and may also differ by region within time. Sample size and sampling strategy are also recorded as they inform the extent to which the results reflect the specific sample or a larger population. The operationationalization of the RACE measures are of central importance. While “Brown” may be noted in English, there are several Portuguese terms that fall under this crude translation, including “Pardo”, “Moreno”, and “Mestizo”, among others. Similarly, both the Portuguese “Preto” and “Negro” correspond to the English translation of “Black”. However, the social science literature indicates that each of these terms has different meanings across time, region, and RACE group and likely has different implications for health; thus, the original Portuguese translation is used. I also note whether race is respondent-reported or interviewer-assessed and whether the interviewer-assessed category is more subjective (e.g., a scale of one to ten) or more objective (e.g., matching a color palette to facial color). Self-reported RACE category may reflect personal psychosocial processes against the backdrop of broader social processes whereas interviewer-assessed RACE category may reflect both how the respondent is perceived by others and the burden of social, economic, and political constraints that are important for health. Regarding the health outcomes, I note how the outcomes are ascertained through objective (e.g., blood pressure cuff) or subjective (e.g., self-report) measurement. In multivariate analyses, I also note the covariates included. Finally, I discuss health inequalities by RACE measures integrating the social science literature on the topic and making recommendations for future measurement and analysis of RACE constructs in the future. Maria do Carmo Leal Iniquidades raciais na assistência ao parto Continuam enormes as disparidades sociais e de acesso aos serviços de saúde entre as mulheres brancas e as pretas e pardas no Brasil. Este trabalho utilizou os dados da pesquisa Nascer no Brasil, realizada em 2012, para abordar as iniquidades raciais em relação à assistência ao pré-natal, parto e nascimento, buscando comparar os resultados atuais com estudos anteriores já publicados no país. Verificou-se que as diferenças sociais e raciais persistiram entre essas mulheres mesmo quando as análises foram controladas pelo nível de escolaridade, apresentadas a seguir: As mulheres pretas e pardas corresponderam a 9% e 57% do total, entretanto estiveram sete e quatro vezes mais representadas nas classes D e E, quando comparadas com as brancas das classes A e B. Essas desvantagens também se expressaram quanto à situação conjugal, por ausência de companheiro e na oportunidade de trabalho remunerado. Foi maior a paridade e mais elevado o risco de alcoolismo durante a gestação entre as mulheres pretas e pardas, bem como foi maior a chance de receber uma assistência prénatal inadequada. As prevalências de doenças infecciosas tais como sífilis e infecção pelo HIV foram mais elevadas nas mulheres pretas. Em todas as análises há um gradiente, com aumento do risco, à medida que escurece a cor da pele. Foi menor a chance de ter um acompanhante durante o trabalho de parto e parto e maior a chance de ter um parto vaginal e uma gestação pós-termo nas mulheres pretas e 12

pardas, que tiveram simultaneamente a vivência de um parto mais doloroso, com uso de ocitocina (para aceleração do trabalho de parto), episiotomia e manobra de Kristeller. Por outro lado, as mulheres pretas e pardas apresentaram um índice de integridade corporal (sem cortes e cicatrizes) maior que as brancas, decorrente do menor número de cesarianas entre elas. A integridade corporal tem sido utilizada como um indicador de qualidade da assistência ao parto no Reino Unido. Importa destacar que esse benefício alcançado pelas mulheres pretas e pardas no Brasil significa também certo abandono na atenção a elas, já que o modelo vigente de atenção ao parto é intervencionista e intervenções, mesmo quando desnecessárias, são confundidas pela população com um bem cuidar da saúde. Foi por isso que essas mulheres também apresentaram maiores proporções de partos naturais (sem nenhuma intervenção obstétrica) do que as brancas, sendo esse outro indicador de qualidade da assistência obstétrica. A vivência dolorosa do trabalho de parto e a “percepção de terem recebido uma menor atenção” durante a hospitalização podem ser o motivo para a pior avaliação quanto ao atendimento recebido por parte das mulheres pretas e pardas, já que nesse estudo o contato com os profissionais de saúde foi o principal fator para a satisfação materna com o atendimento. De um modo geral, esses resultados reafirmaram a existência de preconceito racial na sociedade brasileira. Sarah Burgard In my initial work on race and health in Brazil, conducted for my dissertation, I focused on the ways that legal and social conditions shape how race or color affect women during their pregnancies and children in early life. I compared the cases of Brazil and South Africa, both nations with extremely high levels of inequality, and with racially diverse populations, but with very different histories of race-related privilege, racial demographies, and levels of publicly-available and subsidized health care. In a series of papers examining nationally-representative survey data on children’s growth in height and weight, and women’s use of prenatal and delivery care, I explored the extent to which differences across groups in socioeconomic status and other factors could help to explain differences in these outcomes. Most of the differences in Brazil were explained by accounting for stratification in socioeconomic conditions and communities of residence, while less was explained of the larger gaps in the South African case. Explanations for these differences touched on the role of discriminatory treatment by race or color and how it likely varied across these contexts, though I was unable to directly measure discrimination in these studies. In more recent work focused on U.S. adults, I have been interested in understanding race/ethnic, gender, and socioeconomic disparities in health over adulthood. I have focused on differences across these groups in employment quality and working conditions. Employment is the crucial bridge between educational attainment and income, both of which are crucially important for health as well, but we spend much of our adult lives at work, so exposures there matter substantially as well. Work provides access not only to income, but also (in the U.S.) to health insurance and other benefits, social integration, and other factors important for health. Work may also be an important site for exposure to unfair treatment, whether in terms of discrimination in hiring, promotion, or job termination, or in terms of interpersonal discrimination at the workplace. I have not studied discriminatory treatment at work or in other institutions (such as the health care setting) as much as I would like to, and am interested in planning some analyses that might help us better understand the workplace’s role in racial disparities in health in the U.S. 13

I also study how other stressors, from negative life events like job loss or health shocks, to experiences of unfair treatment or levels of vigilance, are differentially distributed by race, and how these are associated with health outcomes from sleep quality to mortality. I am very interested in expanding this line of research to better understand the ways that intersectional identities matter for health, by considering combinations of identities: most centrally, race/ethnicity (or color) and gender and level of socioeconomic resources (education, income, occupation). In some recent work with one of my panel surveys, I have been examining the ways that intersectional race and gender identities among U.S. adults are linked to their use of preventive health practices ranging from getting basic medical screenings like cholesterol or blood sugar checks, to avoidance of smoking or obesity, to specific dietary choices. We find that African American women are quite distinctive from both White American women and African American men, for example, and that white men also show unique differences from all of the other three groups in some of these behaviors. The mechanisms underlying these are complex, but looking at intersectional groups helps to identify where we may be seeing a gender difference more broadly (such as we find for aspirin use for heart health), versus a situation uniquely affecting minority women (such as many studies in the U.S. have found for high body mass index). Sociologists have thought a lot about classifications of race in the U.S., and of gender and social class. There is much to be done to incorporate a more intersectional approach to these categories in U.S. health research. Moreover, I have begun to work with Professor Chor and her team on a study of differential exposure to discrimination in Brazil (using the ELSA study) and in the U.S. (using our ACL study) for adults, based on their intersectional identities of race, gender, and educational attainment. We are exploring how the divergent histories of Brazil and U.S. may have shaped contemporary experiences of unfair treatment across these intersectional groups. We are also navigating the challenges of comparing race categories (and intersectional groups) across societies, so that we can conduct the statistical analyses in parallel. Given the different socio-legal histories, we are interested in the patterning of reported discriminatory treatment, and whether we find more similarities or more differences in this patterning. My presentation will center largely on the findings from this paper. I will also lay out research questions and an agenda to move forward with comparative research on the implications of discriminatory experiences for cardiovascular health, depressive symptoms, and health behaviors in Brazil and the U.S.

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Sherman A. James The Strangest of all Encounters: Racial and Ethnic Discrimination in Health Care “Of all the forms of inequality, injustice in health is the most shocking and inhuman." Dr. Martin Luther King, Jr. March 25, 1966 Chicago, Illinois, USA The above famous quote by Dr. Martin Luther King, Jr. is from a speech he gave at the 1966 annual meeting of the Medical Committee for Human Rights, an organization of US physicians that provided medical care coverage to civil rights workers, including Dr. King, who worked (often under life threatening conditions) to end de jure racial segregation in the US South. Passage of the landmark 1964 Civil Rights Act, two years earlier, made racial discrimination in health care,and other areas, illegal in the US. However, most hospitals in the US South remained racially segregated until 1965 when a key provision of the newly passed Medicare and Medicaid Act prohibited using federal funds to pay for health care provided by racially segregated hospitals. Southern hospitals desegregated almost overnight to retain their eligibility for these funds. But, by 1966, it had become clear to the Medical Committee for Human Rights thathospitals, in the non-South as well as South, were practicing subtle (but still conscious and deliberate) forms of racial discrimination: Black patients, even in the so-called desegregated hospitals, were simply not receiving the same quality of health care as White patients. And this was the context for the above statement by Dr. King. Nearly 50 years later, the problem of racial (and ethnic) discrimination in health care persists; except today, the discrimination is more likely to be unconscious than conscious and intentional. This hardly lessens the seriousness of the problem, however. As documented by the Institute of Medicine in an influential 2003 report summarizing hundreds of studies conducted in the US during the previous two decades, Black Americans were more likely than Whites to receive substandard care for a wide range of conditions, such as heart disease, diabetes, mental health, and some cancers, conditions for which timely and appropriate health care are known to enhance both the quality and length of life. To date, most studieshave compared Blacks and Whites, but increased attention is being paid to health care inequities experienced by Hispanics/Latinos, the country’s largest minority group. Because few 21st century health care providers would admit to consciously providing substandard care to racial/ethnic minorities, a general consensus exists that current racial and ethnic disparities in health care are due largely to unconscious as opposed to conscious processes. Hence, one of the most excitingareas of contemporary research on racial/ethnic disparities in health care, at least in the US, aims to illuminate these unconscious medical decision-making processes and their connection to deep seated, (i.e. unconscious) negativestereotypes about dark skin people that operate in the US and elsewhere. Realistically, it is unreasonable to expect physicians, and other highly influential actors in health care, most of whom come from privileged backgrounds, to be completely immune to the psychological effects of these unconscious stereotypes. In conclusion, in this presentation, I will selectively summarize contemporary US research on racial/ethnic disparities in health care, with special emphasis on the role of unconscious bias. I will comment on theoretical and methodological challenges facing researchers in this area; and time permitting, I will also comment on implications for education and training. 15

Sueann Caulfield & Alexandra Minna Stern This paper explores the biotechological, legal, and social development of DNA testing in Brazil, focusing especially on how it has been imbued with contested social values regarding race and family. A central concern is the rise of paternity testing and its role in both public (i.e., legal) and private judgments and understandings of family and identity. We analyze the racialized dimensions of paternity testing, as a form of biological “truth telling” that arose alongside population genetics concerned with race and ethnicity, blood and HLA testing connected to medicalized racial groups, and the introduction of DNA tests (mDNA, Y chromosome, autosomal, and exome) that have been used to assess biomedical risk and racial ancestry. We then trace the scientific developments that created successively more accurate DNA testing and the increasingly accessibility of this testing to the general public over the past few decades and discuss the impact of this technology on law and legal practice, specifically in adjudication of lawsuits over paternity and inheritance. We conclude by addressing the problem of how to assess the personal, psychological effects of this new technology at the level of individual families. For example, we will explore the following questions: How does biological “truth” might influence existing emotional bonds? Does the existence of accurate paternity testing influence cultural practices or expectations of fathers? Does it change more general perceptions of family and kinship, or of race or other markers of belonging? This paper will draw on secondary literature, primary and archival sources, and probably some interviews with key figures in the development of DNA paternity testing in Brazil. Tábita Hünemeier Genetic Ancestry in Admixed Populations: implications for evolution and health studies The proportion of human genetic variation due to differences between populations is modest, and individuals from different populations can be genetically more similar than individuals from the same population. Yet sufficient genetic data can permit accurate classification of individuals into populations. The apparent paradox stated in the above sentence is a common outcome in human genetic diversity studies, corroborated since the 60s until to the recent genomic studies involving different human populations. It is well known that despite the strong genetic similarity among major human continental groups (Africans, Europeans, Asians and Native Americans), the last 60,000 years of partially independent evolutionary history on every continent have left some marks on DNA of each of these populations, creating ethnic-specific genetic differences. In other words, the pattern of human genetic diversity was shaped by a demographic expansion from Africa. In this context, specific genetic variations that arise in a given population are rare, but exist. However, large differences in the frequency of certain genetic variants are common among populations. Some of these variants are responsible for visible phenotypes, and are often associated with "typological" or “race” categories, such as blue eyes, blond hair, and lighter skin color, as observed in Northern Europeans. It is also known that certain human continental groups present genetic differences relating to the predisposition to diseases, examples are the cystic fibrosis in Europeans and the sickle cell anemia in Africans. All the observations mentioned above are valid and easily understood when considered mainly the four great continental groups already mentioned. However, what happens to these claims when we focus on recent migration history of countries like Brazil? 16

How to deal with issues related to morphological phenotypes, or susceptibility to diseases, in a recent and admixed population? The current Brazilian population presents a particular composition within the Latin American context, and is mainly composed by recent admixture among three parental groups: Native Americans, Europeans and Africans. Brazil presents an admixed and multiethnic population, which still features original indigenous populations and isolated immigrants in some regions. This variability and genetic heterogeneity of the Brazilian population is the result of five centuries of mass immigration and miscegenation among the groups who lived here. Whereas the foregoing, the purpose of this presentation will be highlight the differences and similarities between Brazil and other Latin American countries with regard to their genetic makeup, as well as show how the concept of genetic ancestry can be used in a manner unrelated to the typological concept of race. It will be also discussed the usefulness of information of genetic ancestry to the appreciation of the differences between individuals of the admixed and multi-ethnic population, and its value as a tool for health studies in the same population. Tania Salgado Pimenta Saúde e escravidão na medicina brasileira do oitocentos Nesse trabalho pretendemos analisar três pontos relacionados à escravidão e à medicina no Brasil do Oitocentos. Por um lado, nos interessa abordar a importância do escravo/africano e descendentes na construção do conhecimento médico, através do estudo de seus corpos doentes ou mortos. Por outro, também atentaremos para a relação estabelecida pelos médicos entre esses indivíduos e doenças específicas. Um terceiro aspecto refere-se à própria assistência oferecida pela medicina oficial aos escravizados, cuja investigação é mais limitada pelas fontes. Para tanto, recorremos à produção historiográfica e a fontes primárias - principalmente, relatórios de Ministério do Império, do hospital da Santa Casa da Misericórdia do Rio de Janeiro, de teses apresentadas à Faculdade de Medicina do Rio de Janeiro.

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Seminário “Raça, Discriminação e Saúde: Perspectivas Históricas e Contemporâneas” Mini CV dos Participantes Alexandre Pereira Graduado em Medicina pela Universidade de São Paulo (1999) e doutorado em Cardiologia pela Faculdade de Medicina da Universidade de São Paulo (2008). Atualmente é médico assistente do Instituto do Coração – Hospital das Clínicas – FMUSP. Trabalha no Laboratório de Genética e Cardiologia Molecular do Instituto do Coração (Incor) HCFMUSP, onde coordena o grupo de genética humana. Seus principais interesses são a identificação e caracterização de fatores genéticos que causem ou module fenótipos cardiovasculares. Alexandra Minna Stern Professor of Obstetrics and Gynecology, American Culture, History, and Women’s Studies at the University of Michigan. There she is a core faculty member in the Latina/o Studies Program; the Science, Technology, and Society Program; directs the Center for Latin American and Caribbean Studies/Brazil Initiative and co-directs the Reproductive Justice Faculty Program at the Institute for Research on Women and Gender. Her research has focused on the uses and misuses of genetics in the United States and Latin America. She is the author of Eugenic Nation: Faults and Frontiers of Better Breeding in Modern America (University of California Press, 2005), which won the American Public Health Association’s Arthur Viseltear Award for outstanding contribution to the history of public health. Her latest book, Telling Genes: The Story of Genetic Counseling in America (Johns Hopkins University Press, 2012) is a Choice 2013 Outstanding Academic Title in Health Sciences. She has held numerous grants for her work in medical history and health policy, including from the National Endowment for the Humanities, National Institutes of Health, and the Robert Wood Johnson Foundation. She is currently leading a project to create a dataset of 15,000 eugenic sterilization orders processed by the state of California in the 20th century and is principal investigator on a Ford Foundation grant to assess the status of reproductive rights and justice organizations and issues in Michigan. Antônio Sergio Guimarães Possui graduação (1972) e mestrado (1982) em Ciências Sociais pela Universidade Federal da Bahia, e doutorado em Sociologia pela University of Wisconsin - Madison (1988). Atualmente é professor titular da Universidade de São Paulo e da Chaire de Sciences Sociales Brésiliennes Sérgio Buarque de Holanda, Fondation Maison des Sciences de l'Homme. Foi Visiting Fellow e Visiting Professor de diversas universidades e centros de pesquisa no exterior - University of Illinois, Urbana-Champaign, Freie Universität Berlin, Princeton University., University of California - Los Angeles, Ecole des Hautes Etudes en Sciences Sociales, Institut de Recherche pour le Dévoloppment. Tem experiência na área de Sociologia, com ênfase em estudos afrobrasileiros e formação de classes sociais, atuando principalmente nos seguintes temas: identidades raciais, regionais e nacionais, racismo e desigualdades raciais. Claudia Travassos Graduada em Medicina pela Universidade Federal Fluminense (1975), mestrado em Saúde Coletiva pela Universidade do Estado do Rio de Janeiro (1981), mestrado em Medicina 18

Comunitária pela London School of Hygiene And Tropical Medicine (1985) e doutorado em Administração Pública pela London School of Economics and Political Sciences (1992). Realizou estágio Pós-Doutoral na Universidade de Michigan (2002) com o Professor David Williams. Pesquisadora titular do Laboratório de Informações em Saúde do Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Atualmente é Coordenadora do Centro Colaborador para a Qualidade do Cuidado e a Segurança do Paciente (PROQUALIS) e Editora-Chefe do Cadernos de Saúde Pública (FIOCRUZ). Desenvolve pesquisa em Saúde Coletiva, atuando principalmente nos seguintes temas: avaliação de sistemas e serviços de saúde, equidade e serviços de saúde, acesso e utilização de serviços de saúde, qualidade do cuidado de saúde e segurança do paciente. Dora Chor Formada em Medicina pela Faculdade de Ciências Médicas da Universidade Estadual do Rio de Janeiro (1979), é Mestre em Saúde Pública pela Fundação Oswaldo Cruz e Doutora em Saúde Pública pela Universidade de São Paulo (1987). Foi Pesquisadora Visitante do “Center for Social Epidemiology and Population Health”- UMICH (2001-2002). É Pesquisadora Titular da Escola Nacional de Saúde Pública – FIOCRUZ . Foi coordenadora (2007-2013), no Rio de Janeiro, do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Interesses de pesquisa e docência incluem o impacto dos determinantes sociais de saúde nas doenças crônicas não transmissíveis, com ênfase 1. nos efeitos simultâneos das condições socioeconômicas ao longo da vida, cor/raça e gênero; 2. na mobilidade social intra e intergeracional. Publicações recentes de interesse para este seminário incluem: Chor, D. Desigualdades em saúde no Brasil: é preciso ter raça. Cad. Saúde Pública, 2013; Chor D et al. Prevalence, Awareness, Treatment and Influence of Socioeconomic Variables on Control of High Blood Pressure: Results of the ELSA-Brasil Study. PLoS One 2015; Chor D et al. Social inequalities in BMI trajectories: 8-year follow-up of the Pró-Saúde study in Rio de Janeiro, Brazil. Public Health Nutr 2015. Eduardo Faersten Graduou-se em Medicina pela Universidade do Estado do Rio de Janeiro (UERJ, 1976). Possui mestrado em Medicina Social pelo Instituto de Medicina Social (IMS) da mesma universidade (1987), e doutorado em Epidemiologia (PhD) na Johns Hopkins University, EUA (1995). É Professor Associado e Chefe (2013-15) do Departamento de Epidemiologia do IMS-UERJ, onde integra o corpo permanente do Programa de Pós-Graduação (PPG) em Saúde Coletiva - Capes nível 7. Integra também o corpo docente permanente do PPG em Alimentação, Nutrição e Saúde da UERJ. Foi Professor Visitante (pós-doutorados) na Universidade de Michigan, EUA (Center for Social Epidemiology & Population Health, 2001-2), e na Universidade da California-Berkeley, EUA (School of Public Health, 200910). Foi docente do Joint Medical Program da UC Berkeley/San Francisco em 2011 e 2012. Coordenou a Área de Saúde do Programa de Iniciação Científica da UERJ (2009-10). É Editor Associado do American Journal of Epidemiology. Pesquisador CNPq 1-B e Cientista de Nosso Estado - Faperj, coordena a Rede de Pesquisa Pró-Saúde: Determinantes Sociais da Saúde, e o Estudo Pró-Saúde, investigação longitudinal de cerca de 4 mil participantes, iniciado em 1999 no RJ. Coordena lista nacional de debates sobre Determinantes Sociais da Saúde desde 2008, e o Centro Rio de Saúde Global. Cumpriu 4 mandatos nos colegiados superiores da Uerj: Conselho Universitário (2003-6) e Conselho Superior de Ensino e Pesquisa (2007-10). Tem atuado principalmente nas seguintes áreas: determinantes sociais da saúde, epidemiologia do curso de vida, doenças crônicas não transmissíveis do adulto, saúde da mulher e métodos epidemiológicos. No período 1997-2014 concluiu a orientação de 32 bolsistas de I. Científica, 21 mestres, 15 doutores e 6 pós-doutores. 19

Eduardo Tarazona Culturally I come from human population genetics and physical anthropology, geographically I am an admixed Peruvian, and spent years in the continental Europe (in Italy, where the physical anthropology community is asking its Parliament (as in France) to delete the term race from the Constitution), and then also spent years in US-NIH where the term race is much more accepted and used, before to come to Brazil (already 8 years ago). I am currently an Associate Professor at the Federal University of Minas Gerais, Belo Horizonte, Brazil. Elena Calvo-González Is currently a lecturer in the Department of Sociology and the Postgraduate Programme of Social Sciences at the Universidade Federal da Bahia, Brazil. Her research interests include race, biomedicine, biotechnology, and the body. She is currently researching practices of domestic storage of medical documents amongst private and state health care service patients in Brazil. Jerônimo Muniz Professor Adjunto do Departamento de Pós-graduação em Sociologia da Universidade Federal de Minas Gerais (UFMG). Diretor do Centro de Pesquisas Quantitativas em Ciências Sociais (CPEQS/UFMG) e coordenador do Programa de Treinamento Intensivo em Metodologia Quantitativa (MQ) da UFMG. PhD em Sociologia/ Demografia pela University of Wisconsin, Madison. João Luiz Bastos Atualmente é membro da Comissão de Combate ao Preconceito e Promoção de Ações Afirmativas da Universidade Federal de Santa Catarina, bem como do Instituto Nacional de Ciência e Tecnologia para Inclusão do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). Possui mestrado e doutorado em Epidemiologia. Completou seu doutorado em Epidemiologia na Universidade Federal de Pelotas, Brasil, em 2010, trabalhando com a aferição de experiências discriminatórias autor relatadas em adultos brasileiros. Atualmente, é professor Adjunto III do Departamento de Saúde Pública da Universidade Federal de Santa Catarina. Bastos é um estudioso dos efeitos da discriminação racial sobre a saúde. Em particular, foi o autor principal da primeira revisão sistemática da literatura sobre escalas para avaliar discriminação racial como determinante da saúde, publicada no periódico Social Science & Medicine. Também publicou trabalhos acerca de aspectos metodológicos e conceituais relativos à associação entre discriminação e saúde, desenvolveu uma abordagem de três estágios para mensuração da discriminação e foi autor sênior das primeiras revisões sistemáticas da literatura sobre discriminação, saúde mental e pressão arterial. Já publicou mais de 60 artigos em periódicos científicos, 4 capítulos de livro e 1 livro sobre a investigação das relações entre discriminação e saúde no Brasil. É um dos pesquisadores do Estudo EpiFloripa, uma investigação de coorte prospectiva que avalia efeitos de exposições socioeconômicas sobre a saúde de amostra representativa de adultos residentes em Florianópolis, Sul do Brasil. Bastos é revisor de 12 periódicos científicos nacionais e internacionais, além de prestar consultoria para o CNPq e a Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. Em 28 de junho de 2015, contabilizava um total de 367 citações na base Scopus, com um índice H de 12. Joel D. Howell 20

Is the Victor Vaughan Professor of the History of Medicine at the University of Michigan, where he is also a professor in the Departments of Internal Medicine (Medical School), History (College of Literature, Science, and the Arts), and Health Services Management and Policy (School of Public Health). He received his MD and completed his residency in internal medicine at the University of Chicago. He received a PhD in the History and Sociology of Science from the University of Pennsylvania, where he was a Robert Wood Johnson Clinical Scholar. From 1993 to 2007 he directed the Robert Wood Johnson Clinical Scholars Program at the University of Michigan. Howell’s historical work focuses on medical technology, examining how social and contextual factors have shaped its diffusion and clinical application. He attempts to understand why American medicine has become so obsessed with science and technology, and tries to understand policies that have both contributed to and slowed the diffusion of medical technology. Recent projects have started to explore the history of medical education in Ethiopia and the history of cardiology in Brazil. He is also writing on the history of human experimentation and on ideas about heart attacks. As Director of The Medical Arts Program at the University of Michigan, he is studying the effects of the arts on clinical practice with a grant from the Doris Duke Charitable Foundation. Howell’s publications have appeared widely in the medical and the historical literature. His research has been supported both by federal grants and by foundations (he received a Robert Wood Johnson Foundation Investigator Award in Health Policy Research and a Burroughs Welcome Foundation Award in the History of Medicine). In 2013 he received the Nicholas E. Davies Memorial Scholar Award for Scholarly Activities in the Humanities and History of Medicine from the American College of Physicians. In addition to his medical publications, Howell is the author of “Washtenaw County Bike Rides” (University of Michigan Press). Dr. Howell is a practicing internist and attending physician in both the outpatient and inpatient settings and regularly teaches in the Medical School and the College of Literature, Science and the Arts. Lia Schucman Possui graduação (2003) e mestrado (2006) em Psicologia pela Universidade Federal de Santa Catarina doutorado em Psicologia Social pela Universidade de São Paulo (2012) com estagio de doutoramento como Pesquisadora visitante no Center for New Racial Studies Institute for Social, Behavioral and Economic Research (ISBER) da Universidade da California, Santa Barbara. Atualmente é bolsista FAPESP e realiza pesquisa de pós doutorado em Psicologia Social pela Universidade de São Paulo no Projeto de Pesquisa "Famílias interraciais: estudo psicossocial das hierarquias raciais em dinâmicas familiares" . Publicou recentemente o livro “entre o encardido o branco e o branquíssimo: raça, hierarquia e poder na construção da branquitude paulistana.

Leny Trad Doutorado em Ciencias Sociales y Salud (Universitat de Barcelona, 1996). Pós-doutorado no Centre de Recherches et d'Études en Anthropologie (CREA/ Lyon 2) ; Estágio sênior no Department of Black and Latino Studies da Baruch College/CUNY/USA. Professora associado IV do Instituto de Saúde Coletiva/UFBA onde coordena o Programa de pesquisa “Comunidade, Família e Saúde - Contextos, Trajetórias e Políticas Públicas”. Desenvolve pesquisas/ publicações e/ou atividades de extensão nas seguintes áreas temáticas: Vulnerabilidade, Proteção Social, Mobilização e Políticas Públicas; Família, Redes e o Processo Saúde- doença-cuidado; Contextos Sociais, Modos de Vida e Práticas de Saúde; Raça, Etnicidade e saúde; Itinerários terapêuticos, Cronicidade e Cuidado Integral em 21

Saúde. Editora associada da revista L'Ethnographie - Nouvelle Édition. Pesquisador 1d CNPq Luís Eduardo Batista Sociólogo, doutor em Sociologia pela Universidade Estadual Paulista-UNESP-Araraquara. Foi o primeiro coordenador da Área Técnica Saúde da População Negra da Secretaria de Estado da Saúde do Estado de São Paulo (2003-2010). Iniciativa que desencadeou a estruturação de áreas técnicas e grupo gestor da saúde da população negra em todo país. Foi o primeiro gestor a incluir o tema saúde da população nos instrumentos de gestão do Sistema Único de Saúde (Plano Estadual de Saúde, Plano Pluri-anual e Relatório de Gestão). Coordenou o Núcleo de Investigação em Serviços e Sistemas de Saúde do Instituto de Saúde da Secretaria de Estado da Saúde de São Paulo (2011 à 2014). Atualmente é membro da Comissão de Ciências Sociais e Humanas em Saúde da Associação Brasileira de Saúde Coletiva-ABRASCO. Vem desenvolvendo estudos sobre desigualdades raciais e saúde. Maria do Carmo Leal Professor at the National School of Public Health (NSPH) – Oswaldo Cruz Foundation (Fiocruz), Brazilian Ministry of Health – and a Senior Researcher of the Brazilian National Council of Research. She is a Lead Researcher, who has led several investigations into Maternal and Child Health with emphasis in Epidemiology and program evaluation in her country. Her areas of scientific expertise also include Primary Health Care; Birth and Childbirth; Inequalities in Health; Maternal, Newborn and Child Mortality. Maria do Carmo Leal directs program and project grants funded by the Brazilian National Council of Research and the Brazilian Ministry of Health. Recently, she has coordinated a major national multi-center study, called Birth in Brazil: a national survey into Labor and Birth, whose results contributed to supporting the development of an agreement among the Brazilian Ministry of Health, the National Agency of Supplementary Health and private hospitals in order to promote normal labor and birth, as well as the reduction of unnecessary CS. During all Maria do Carmo Leal's career, she has worked as a Graduate Professor of Epidemiology in the NSPH/Fiocruz, where she was the Director of the NSPH, the Vice President of Education, Information and Communication of Fiocruz, and the Director of Fiocruz Press. She was also the coordinator of the National Epidemiology Commission of the Brazilian Association of Public Health, and she has received the Rio de Janeiro State Scientist Award three times. Ricardo Ventura Santos Formado em Ciências Biológicas pela Universidade de Brasília (1987), é Mestre e Doutor em Antropologia pela Indiana University (1991). É Professor Associado IV no Departamento de Antropologia do Museu Nacional/UFRJ e Pesquisador Titular na Escola Nacional de Saúde Pública/Fiocruz. Interesses de pesquisa e docência incluem etnicidade e saúde; antropologia da ciência; e saúde dos povos indígena. Publicações recentes sobre raça e etnicidade incluem as coletâneas “Raça como Questão: História, Ciência e Identidades no Brasil” (Rio de Janeiro, Editora Fiocruz, 2010) “Racial Identities, Genetic Ancestry, and Health in South America" (New York, Palgrave, 2011) e “Mestizo Genomics: Race Mixture, Nation, and Science in Latin America” (Durham, Duke University Press, 2014). Sarah Burgard I am trained as a demographer, sociologist, and epidemiologist. I use quantitative research methods and use publicly-available survey or other kinds of large scale data, or survey data 22

that I have helped to collect myself. I am chiefly interested in the social factors that underlie disparities in health, mainly focusing on the ways that socioeconomic status, gender, and race/ethnicity matter for health in contemporary high and middle-income countries. Much of my recent research has looked at adult health in the United States, with a focus on how employment, working conditions, family responsibilities, material hardship, and life events and psychosocial stressors (including discrimination) are meaningful for mental and physical health and mortality. Sherman A. James Was appointed a Research Professor of Epidemiology and African American Studies at Emory University on July 1, 2014. Prior to his retirement from Duke University on June 30, 2014, he was the inaugural Susan B. King Professor of Public Policy in Duke’s Sanford School of Public Policy from 2003-2014. At Duke, he also held professorships in Sociology, Community and Family Medicine, and African and African American Studies. Prior to joining Duke’s faculty, he taught in the epidemiology departments at the University of North Carolina-Chapel Hill (1973-89) and at the University of Michigan (1989-03). At Michigan, he was the John P. Kirscht Collegiate Professor of Public Health, the Founding Director of the Center for Research on Ethnicity, Culture and Health (CRECH), Chair of the Department of Health Behavior and Health Education, and a Senior Research Scientist in the Survey Research Center at the Institute for Social Research. He received his AB degree (Psychology and Philosophy) from Talladega College (AL) in 1964, and his PhD degree (Social Psychology) from Washington University in St. Louis, in 1973. He is the originator of the John Henryism Hypothesis which posits that repetitive high-effort coping with social and economic adversity is a major contributor to the well-known excess risk among poor and working class African Americans for hypertension and related cardiovascular diseases. Using large data sets, James conducts quantitative research on the social determinants of US racial and ethnic health disparities. With a grant from the Robert Wood Johnson Foundation, he is completing a book length manuscript on the likely social and psychological mechanisms through which 1960s civil rights era legislation (i.e., The Great Society legislation) dramatically, but only briefly, narrowed US Black/White racial health disparities. A social epidemiologist, James was elected to the Institute of Medicine of the National Academy of Sciences in 2000. In 2001, he received the Abraham Lilienfeld Award from the Epidemiology section of the American Public Health Association for career excellence in the teaching of epidemiology. He is a fellow of the American Epidemiological Society, the American College of Epidemiology, the American Heart Association, and the Academy of Behavioral Medicine Research. In 2007-08, he served as president of the Society for Epidemiologic Research (SER). In 2008, he was named a Distinguished Alumnus of Washington University in St. Louis. Sueann Caulfield Associate Professor of History at the University of Michigan, where she was the former director of the Center for Latin American and Caribbean Studies and currently heads the Brazil Initiative Social Sciences Cluster. She specializes in the history of modern Brazil, with emphasis on gender and sexuality. She has won awards and fellowships from the Fulbright Commission, National Endowment for the Humanities, and American Council of Learned Societies. Her publications include In Defense of Honor: Morality, Modernity, and Nation In Early Twentieth-Century Brazil, the co-edited volume Honor, Status, and Law in Modern Latin American History, and various articles on gender and historiography, family law, race, and sexuality in Brazil. Her current research focuses on family history with a focus on paternity and legitimacy in twentieth-century Brazil. She is particularly interested 23

in questions of human rights in Latin America, and has participated in a number of workshops, cross-country teaching projects, and exchanges around topics of social justice and social action. Tábita Hünemeier Bachelor of Science in Biological Science (Universidade Federal do Rio Grande do Sul, 2003), Master of Science in Genetics and Molecular Biology (Universidade Federal do Rio Grande do Sul, 2006) and PhD in Sciences (Universidade Federal do Rio Grande do Sul/Univesity College London, 2010). Currently she is professor in the Department of Genetics and Evolutionary Biology at the University of São Paulo. Her research work is on the study of human genetic diversity, aiming to identifying the processes and the patterns that shaped the evolutionary trajectories of different human populations, mainly Native Americans and Latin Americans populations. Tania Salgado Pimenta Possui formação em História com graduação (1994) pela Universidade Federal do Rio de Janeiro e mestrado (1997) e doutorado (2003) pela Universidade Estadual de Campinas. Entre 2004 e 2007 foi pesquisadora bolsista do Instituto de Saúde Coletiva da UFBA. É pesquisadora da Casa de Oswaldo Cruz/Fundação Oswaldo Cruz e professora do Programa de Pós-Graduação em História das Ciências e da Saúde da Fiocruz. Publicou artigos sobre o exercício das artes de curar, a assistência hospitalar, saúde e escravidão e as epidemias no Rio de Janeiro do século XIX. Organizou, junto com outros pesquisadores, dossiês sobre essas temáticas e o livro “Filantropos da Nação” (Rio de Janeiro, FGV Editora/Faperj, 2015)

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