The main focus of DR's research is to analyze the impact of adverse exposures (e.g. poverty, violence, income inequality), on the health and development of vulnerable populations in different life stages.
EDUCATION
She holds a degree in Psychology (UERJ - 2009), a Master's in Social Psychology (UERJ -2012), a PhD in Epidemiology (IMS UERJ/McMaster University - 2017) and is a Adjunct Professor at the Institute of Collective Health of the Federal University of Bahia, Brazil.
RESEARCH, TEACHING, or OTHER INTERESTS
Epidemiology, Psychology, Social Psychology, Public Health, Environmental and Occupational Health
44
Scopus Publications
1760
Scholar Citations
21
Scholar h-index
33
Scholar i10-index
Scopus Publications
Material deprivation, racial inequalities and mortality from female breast, prostate, and cervical neoplasm in the Brazilian adult population: an ecological study Ana Cristina de Oliveira Costa, Jackson Geraldo de Faria Júnior, Guilherme Lopes de Oliveira, Dandara de Oliveira Ramos, Rômulo Paes-Sousa Ciencia E Saude Coletiva, 2025 This article aims to identify the relationship between material deprivation and mortality from breast, cervical, and prostate neoplasms in the Brazilian adult population and the relationship between ethnicity/skin color and material deprivation. This cross-sectional ecological study calculated the mean mortality rate per 100,000 inhabitants, and deaths were standardized by age and gender and redistributed per to ill-defined causes, stratified by age group and ethnicity/skin color. We applied the Negative Binomial model, containing the interaction between ethnicity/skin color and the Brazilian Deprivation Index (IBP). We analyzed 85,903 deaths, and the most prevalent were those due to female breast neoplasms. The risk of death from cervical cancer was 8.5% higher for Black women than white women. In other places, mortality was higher among white people. For all causes, mortality increased with age. There was a significant interaction between ethnicity/skin color and IBP for all causes. Only deaths due to cervical neoplasms increased with higher IBP, while a decline was observed in other causes but was less significant among Black people. The IBP offers a multidimensional view of the socioeconomic conditions of the Brazilian population, allowing a better understanding of how social determinants operate on selected neoplasms.
A small area deprivation index for monitoring and evaluating health inequalities in a diverse, low and middle income country: the Índice Brasileiro de Privação (IBP) Mirjam Allik, Elzo Pereira Pinto-Júnior, Dandara Ramos, Andrêa Ferreira, Flavia Jose Alves, et al. International Journal of Population Data Science, 2025 IntroductionMonitoring and addressing health inequalities is important. However, socioeconomic variables are usually unavailable within health datasets. Area deprivation measures provide access to open-source reliable socioeconomic data within low/middle-income countries and can contribute to the monitoring of the Sustainable Development Goals and assessing the growing burden of health inequalities. ObjectiveTo create a small-area deprivation measure for the whole of Brazil - the Brazilian Deprivation Index (Índice Brasileiro de Privação - IBP). MethodsUsing Census Sector data (mean population size=615) from the most recently available Brazilian Demographic Census (2010), variables measuring literacy, household income and housing conditions were standardised using z-scores and summed into a single measure. The IBP was validated using regional small-area measures of vulnerability: Belo Horizonte's Health Vulnerability Index (IVS) and S\\~{a}o Paulo's Social Vulnerability Index (IPVS). Mortality data from Minas Gerais were used to estimate age-standardised mortality rates (ASMR) by ill-defined causes across IBP deprivation quintiles. ResultsThe IBP was created for 303,218 (97.8%) census sectors (99.7% population). Substantial regional variation in deprivation was found using the IBP measure, with higher deprivation in rural than urban areas. The IBP was correlated with the other indicators used for validation: the IVS (r = 0.96) and the IPVS (r = 0.68). We found gradients across the ill-defined causes ASMR, in Minas Gerais mortality was 2.6 higher in the most deprived quintile of IBP, compared with the least deprived. Main challenges in creating a deprivation measure for LMICs and possible solutions are demonstrated. ConclusionA small area deprivation index was created for Brazil, a large and highly diverse middle-income country. The IBP improves our understanding and monitoring of inequalities, serving as a valuable tool for informing targeted public policies. Although the index is based on Brazil's specific context, the challenges faced, and the strategies implemented to tackle them are relevant for other low- and middle-income countries aiming to develop similar tools.
Evaluating the relationship between conditional cash transfer programme on preterm births: a retrospective longitudinal study using the 100 million Brazilian cohort Naiá Ortelan, Márcia Furquim de Almeida, Elzo Pereira Pinto Júnior, Nivea Bispo, Rosemeire L. Fiaccone, et al. BMC Public Health, 2024 Background Preterm births increase mortality and morbidity during childhood and later life, which is closely associated with poverty and the quality of prenatal care. Therefore, income redistribution and poverty reduction initiatives may be valuable in preventing this outcome. We assessed whether receipt of the Brazilian conditional cash transfer programme - Bolsa Familia Programme, the largest in the world - reduces the occurrence of preterm births, including their severity categories, and explored how this association differs according to prenatal care and the quality of Bolsa Familia Programme management. Methods A retrospective cohort study was performed involving the first live singleton births to mothersenrolled in the 100 Million Brazilian Cohort from 2004 to 2015, who had at least one child before cohort enrollment. Only the first birth during the cohort period was included, but born from 2012 onward. A deterministic linkage with the Bolsa Familia Programme payroll dataset and a similarity linkage with the Brazilian Live Birth Information System were performed. The exposed group consisted of newborns to mothers who received Bolsa Familia from conception to delivery. Our outcomes were infants born with a gestational age < 37 weeks: (i) all preterm births, (ii) moderate-to-late (32–36), (iii) severe (28–31), and (iv) extreme (< 28) preterm births compared to at-term newborns. We combined propensity score-based methods and weighted logistic regressions to compare newborns to mothers who did and did not receive Bolsa Familia, controlling for socioeconomic conditions. We also estimated these effects separately, according to the adequacy of prenatal care and the index of quality of Bolsa Familia Programme management. Results 1,031,053 infants were analyzed; 65.9% of the mothers were beneficiaries. Bolsa Familia Programme was not associated with all sets of preterm births, moderate-to-late, and severe preterm births, but was associated with a reduction in extreme preterm births (weighted OR: 0.69; 95%CI: 0.63–0.76). This reduction can also be observed among mothers receiving adequate prenatal care (weighted OR: 0.66; 95%CI: 0.59–0.74) and living in better Bolsa Familia management municipalities (weighted OR: 0.56; 95%CI: 0.43–0.74). Conclusions An income transfer programme for pregnant women of low-socioeconomic status, conditional to attending prenatal care appointments, has been associated with a reduction in extremely preterm births. These programmes could be essential in achieving Sustainable Development Goals.
Racial Disparities in Medication Use During Pregnancy: Results from the NISAMI Cohort Caroline Castro, Lisiane Leal, Dandara Ramos, Jerusa Santana, Rosa Cordeiro, et al. Journal of Multidisciplinary Healthcare, 2024 Purpose This study aimed to evaluate racial disparities in medication use and associated factors among pregnant women receiving prenatal care at Brazilian Unified Health System primary care health units in the northeast region. Patients and Methods A total of 1058 pregnant women in the NISAMI Cohort were interviewed between June 2012 and February 2014. Medicines used during pregnancy were classified according to the Anatomical Therapeutic Chemical (ATC) classification system and ANVISA pregnancy risk categories. Prevalence ratios (crude and adjusted) and 95% confidence intervals (CIs) were estimated using Poisson regression with robust error variance. All analyses were stratified by race (Asian, black, brown/mixed, Brazilian indigenous, and white). Results Approximately 84% of the pregnant women used at least one medication, with a lower proportion among white women. The most reported medications were antianemic preparations (71.08%; 95% CI 68.27–73.72%), analgesics (21.74%; 95% CI 19.36–24.32%), and drugs for functional gastrointestinal disorders (18.81%; 95% CI 16.57–21.28%). Approximately 29% of women took potentially risky medications during pregnancy, with a higher prevalence among Asian and white women. Factors associated with medication use during pregnancy include a greater number of prenatal consultations, higher education levels, health problems, and smoking. In addition, maternal age above 25 years, smoking status, and two or more previous pregnancies were associated with potentially risky medication use during pregnancy. Conclusion A high prevalence of medication use during pregnancy was found; however, this prevalence was lower among white women. Nonetheless, black and brown women used antianemic preparations less frequently. This finding suggests that race is a factor of inequity in prenatal care, demanding public policies to mitigate it.
Association of Conditional Cash Transfers with Maternal Mortality Using the 100 Million Brazilian Cohort Flávia Jôse O. Alves, Dandara Ramos, Enny S. Paixão, Ila R. Falcão, Rita de Cássia Ribeiro-Silva, et al. JAMA Network Open, 2023 ImportanceConditional cash transfers (CCTs) have been consistently associated with improvements to the determinants of maternal health, but there have been insufficient investigations regarding their effects on maternal mortality.ObjectiveTo evaluate the association between being a Bolsa Família program (BFP) beneficiary and maternal mortality and to examine how this association differs by duration of BFP receipt, maternal race, living in rural or urban areas, the Municipal Human Development Index (MHDI), and municipal primary health care coverage.Design, Setting, and ParticipantsThis cross-sectional analysis was nested within the 100 Million Brazilian Cohort. Girls and women aged 10 to 49 years (hereinafter referred to as women) who had at least 1 live birth were included, using data from Brazilian national health databases linked to the 100 Million Brazilian Cohort (January 1, 2004, to December 31, 2015). Propensity score kernel weighting was applied to control for sociodemographic and economic confounders in the association between BFP receipt and maternal mortality, overall and stratified by different subgroups (race, urban or rural area, and MHDI), and duration of BFP receipt. Data were analyzed from July 12, 2019, to December 31, 2022.Main Outcome(s) and MeasuresMaternal death.ResultsA total of 6 677 273 women aged 10 to 49 years were included in the analysis, 4056 of whom had died from pregnancy-related causes. The risk of maternal death was 18% lower in women who received BFP (weighted odds ratio [OR], 0.82 [95% CI, 0.71-0.93]). A longer duration receiving BFP was associated with an increased reduction in maternal mortality (OR for 1-4 years, 0.85 [95% CI, 0.75-0.97]; OR for 5-8 years, 0.70 [95% CI, 0.60-0.82]; OR for ≥9 years, 0.69 [95% CI, 0.53-0.88]). Receiving BFP was also associated with substantial increases in the number of prenatal appointments and interbirth intervals. The reduction was more pronounced in the most vulnerable groups.Conclusions and RelevanceThis cross-sectional analysis nested within the 100 Million Brazilian Cohort found an association between BFP receipt and maternal mortality. This association was of greater magnitude in women with longer exposure to BFP and in the most vulnerable groups. These findings reinforce evidence that programs such as BFP, which have already proven effective in poverty reduction, have great potential to improve maternal survival.
Conceptions of autonomy in different age groups Maria Lucia SEIDL-DE-MOURA, Luciana Fontes PESSÔA, Deise Maria Leal Fernandes MENDES, Dandara de Oliveira RAMOS, Ana Carolina Monerat FIORAVANTI-BASTOS, et al. Estudos De Psicologia Campinas, 2017
A small area deprivation index for monitoring and evaluating health inequalities in a diverse, low and middle income country: the Índice Brasileiro de Privação (IBP) M Allik, EP Pinto-Júnior, D Ramos, AJF Ferreira, FJ Alves, C Teixeira, ... International Journal of Population Data Science 10 (3), 2974 , 2025 2025 Citations: 2
Privación material, desigualdades raciales y mortalidad por neoplasias de mama, próstata y cuello uterino en la población adulta brasileña: un estudio ecológico ACO Costa, JG Faria Júnior, GL Oliveira, DO Ramos, R Paes-Sousa Ciência & Saúde Coletiva 30, e02212024 , 2025 2025
Material deprivation, racial inequalities and mortality from female breast, prostate, and cervical neoplasm in the Brazilian adult population: an ecological study ACO Costa, JG Faria Júnior, GL Oliveira, DO Ramos, R Paes-Sousa Ciência & Saúde Coletiva 30, e02212024 , 2025 2025 Citations: 1
Privação material, desigualdades raciais e mortalidade por neoplasias de mama feminino, próstata e colo de útero na população adulta brasileira: um estudo ecológico ACO Costa, JG Faria Júnior, GL Oliveira, DO Ramos, R Paes-Sousa Ciência & Saúde Coletiva 30, e02212024 , 2025 2025 Citations: 5
Racial Disparities in Medication Use During Pregnancy: Results from the NISAMI Cohort CT Castro, LF Leal, DO Ramos, JM Santana, RC Cordeiro, ... Journal of multidisciplinary healthcare, 2755-2775 , 2024 2024 Citations: 1
Assistência à Saúde da Criança na Atenção Primária Brasileira:: um Histório dos Principais Marcos Normativos entre 1990-2022 AMP de Lima, HPG dos Santos, L Luz, V Martufi, ... APS EM REVISTA 6 (1), 211-225 , 2024 2024 Citations: 1
Pan-American data initiative for the analysis of population racial/ethnic health inequities: the Pan-DIASPORA project M Carabali, S Barber, AJF Ferreira, AF Ortigoza, D Ramos, E Goes, ... The Lancet Regional Health–Americas 37 , 2024 2024 Citations: 2
Ethno-racial inequalities on adverse birth and neonatal outcomes: a nationwide, retrospective cohort study of 21 million Brazilian newborns P Rebouças, ES Paixão, D Ramos, J Pescarini, EP Pinto-Junior, ... The Lancet Regional Health–Americas 37 , 2024 2024 Citations: 15
Indicadores de desigualdades sociais associados à mortalidade por neoplasias nos adultos brasileiros: revisão de escopo ACO Costa, DO Ramos, RP Sousa Ciência & Saúde Coletiva 29, e19602022 , 2024 2024 Citations: 10
Indicators of social inequalities associated with cancer mortality in Brazilian adults: scoping review ACO Costa, DO Ramos, RP Sousa Ciência & Saúde Coletiva 29, e19602022 , 2024 2024 Citations: 3
Data Initiative for the Analysis of Racial/Ethnic Health Inequalities in Latin American and Caribbean countries: Protocol for a series of Scoping Reviews Y Sanchez, AJF Ferreira, YM Elmi, D Perez, D Ramos, DI Lucumi, ... 2024 Citations: 1
Evaluating the relationship between conditional cash transfer programme on preterm births: a retrospective longitudinal study using the 100 million Brazilian cohort N Ortelan, MF de Almeida, EP Pinto Júnior, N Bispo, RL Fiaccone, ... BMC Public Health 24 (1), 713 , 2024 2024 Citations: 7
The relationship between cash-based interventions and violence: a systematic review and evidence map DB Machado, NT de Siqueira Filha, F Cortes, LFS Castro-de-Araujo, ... Aggression and violent behavior 75, 101909 , 2024 2024 Citations: 19
The combined effect of social pensions and cash transfers on child mortality: evaluating the last two decades in Brazil and projecting their mitigating effect during the global … TJ Aransiola, JA Ordoñez, DM Cavalcanti, GA de Sampaio Morais, ... The Lancet Regional Health–Americas 27 , 2023 2023 Citations: 14
Considerações sobre o quesito raça/cor nos Sistemas de Informação de Vigilância em Saúde MV da Silva Cordeiro, ACC dos Santos, MS Rocha, JS Nery, ... Boletim, 9 , 2023 2023
Racial disparities in medicine use during pregnancy: Results from the NISAMI cohort DB Santos, FL de Carvalho, DO Ramos, LF Leal, CS Lisboa, ... PHARMACOEPIDEMIOLOGY AND DRUG SAFETY 32, 401-402 , 2023 2023
Anti-Black racism and maternal death from COVID-19: what have we seen in the Pandemic? EF Góes, AJF Ferreira, D Ramos Ciencia & saude coletiva 28, 2501-2510 , 2023 2023 Citations: 9
Racismo antinegro e morte materna por COVID-19: o que vimos na Pandemia? EF Góes, AJF Ferreira, D Ramos Ciência & Saúde Coletiva 28, 2501-2510 , 2023 2023 Citations: 25
Racial-based bullying and substance use: a Brazilian national cross-sectional survey among students AAS Menezes, DO Ramos, ZM Sanchez, R Miskolci Journal of racial and ethnic health disparities 10 (3), 1441-1454 , 2023 2023 Citations: 10
Residential segregation, breast cancer mortality and the effect of a conditional cash transfer (bolsa família) programme: Results from the 100 million brazilian cohort JMN Guimarães, JM Pescarini, JF de S Filho, A Ferreira, G Santos, ... Population Medicine 5 (Supplement) , 2023 2023 Citations: 1
MOST CITED SCHOLAR PUBLICATIONS
Desigualdades raciais em saúde ea pandemia da Covid-19 EF Goes, DO Ramos, AJF Ferreira Trabalho, Educação e Saúde 18 (3), e00278110 , 2020 2020 Citations: 332
Propensity score methods in health technology assessment: principles, extended applications, and recent advances MS Ali, D Prieto-Alhambra, LC Lopes, D Ramos, N Bispo, MY Ichihara, ... Frontiers in pharmacology 10, 973 , 2019 2019 Citations: 258
Administrative data linkage in Brazil: potentials for health technology assessment MS Ali, MY Ichihara, LC Lopes, GCG Barbosa, R Pita, RP Carreiro, ... Frontiers in pharmacology 10, 984 , 2019 2019 Citations: 109
Future discounting by slum‐dwelling youth versus university students in Rio de Janeiro D Ramos, T Victor, ML Seidl‐de‐Moura, M Daly Journal of Research on Adolescence 23 (1), 95-102 , 2013 2013 Citations: 93
Cohort profile: the 100 million Brazilian cohort ML Barreto, MY Ichihara, JM Pescarini, MS Ali, GL Borges, RL Fiaccone, ... International journal of epidemiology 51 (2), e27-e38 , 2022 2022 Citations: 74
Ethnoracial inequalities and child mortality in Brazil: a nationwide longitudinal study of 19 million newborn babies P Rebouças, E Goes, J Pescarini, D Ramos, MY Ichihara, S Sena, ... The Lancet Global Health 10 (10), e1453-e1462 , 2022 2022 Citations: 72
Conditional cash transfer program and child mortality: A cross-sectional analysis nested within the 100 Million Brazilian Cohort D Ramos, NB da Silva, MY Ichihara, RL Fiaccone, D Almeida, S Sena, ... PLoS medicine 18 (9), e1003509 , 2021 2021 Citations: 72
Monitoring the progress of health-related sustainable development goals (SDGs) in Brazilian states using the Global Burden of Disease indicators DB Machado, JM Pescarini, D Ramos, R Teixeira, R Lozano, ... Population health metrics 18 (Suppl 1), 7 , 2020 2020 Citations: 47
Developing a small-area deprivation measure for Brazil M Allik, D Ramos, M Agranonik, EP Pinto Júnior, MY Ichihara, ML Barreto, ... University of Glasgow , 2020 2020 Citations: 43
Sistemas de cuidados e o discurso de diferentes cuidadores do Rio de Janeiro: evidências de trajetória de desenvolvimento LF Pessôa, ML Seidl-de-Moura, DO Ramos, DMLF Mendes Estudos de Psicologia (Campinas) 33, 71-82 , 2016 2016 Citations: 38
Effects of sexual orientation-based bullying on feelings of loneliness and sleeping difficulty among Brazilian middle school students RT Jomar, VA de Oliveira Fonseca, D de Oliveira Ramos Jornal de Pediatria 97 (2), 233-241 , 2021 2021 Citations: 35
Autonomy development: Gender and age differences from adolescence to emerging adulthood L Dutra-Thomé, LF Marques, ML Seidl-de-Moura, DO Ramos, S Koller Acta de investigación psicológica 9 (2), 14-24 , 2019 2019 Citations: 33
Tendência da asma na adolescência no Brasil: resultados da Pesquisa Nacional de Saúde do Escolar (PeNSE) 2012 e 2015 RC Ribeiro-Silva, ML Barreto, D Ramos, AA Cruz, M Oliveira-Campos, ... Revista Brasileira de Epidemiologia 21, e180017 , 2018 2018 Citations: 29
Cohort profile: Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS) birth cohort ES Paixao, LL Cardim, IR Falcao, N Ortelan, NJ Silva, AS Rocha, S Sena, ... International journal of epidemiology 50 (1), 37-38 , 2021 2021 Citations: 26
Area deprivation measures used in Brazil: a scoping review MYT Ichihara, D Ramos, P Rebouças, FJ Oliveira, AJF Ferreira, ... Revista de saúde pública 52, 83 , 2018 2018 Citations: 26
Racismo antinegro e morte materna por COVID-19: o que vimos na Pandemia? EF Góes, AJF Ferreira, D Ramos Ciência & Saúde Coletiva 28, 2501-2510 , 2023 2023 Citations: 25
Association of conditional cash transfers with maternal mortality using the 100 Million Brazilian Cohort FJO Alves, D Ramos, ES Paixão, IR Falcão, R de Cássia Ribeiro-Silva, ... JAMA network open 6 (2), e230070 , 2023 2023 Citations: 25
Intersection of race and gender in self-reports of violent experiences and polyvictimization by young girls in Brazil D de Oliveira Ramos, EF Goes, AJF Ferreira Journal of racial and ethnic health disparities 9 (4), 1506-1516 , 2022 2022 Citations: 24
Effect of the zero-tolerance drinking and driving law on mortality due to road traffic accidents according to the type of victim, sex, and age in Rio de Janeiro, Brazil: An … RT Jomar, DO Ramos, VAO Fonseca, WL Junger Traffic injury prevention 20 (3), 227-232 , 2019 2019 Citations: 23
Social, environmental and behavioral determinants of asthma symptoms in Brazilian middle school students—a national school health survey (Pense 2012) RC Ribeiro-Silva, DC Malta, LC Rodrigues, DO Ramos, RL Fiaccone, ... International journal of environmental research and public health 15 (12), 2904 , 2018 2018 Citations: 21