BACKGROUND:
In multiracial societies such as Brazil, race/ethnicity data are essential for measuring, directly and indirectly, the impacts of structural racism on health outcomes1,2,3. Incomplete recording of this variable in health information systems undermines the capacity of the Brazilian Unified Health System (SUS) to identify health inequalities and to guide equitable public policies for historically marginalized populations, particularly Black and Indigenous peoples2,3–6. This study analyzes the completeness of race/ethnicity information in major national health surveillance information systems over time.

METHODS:
We conducted an ecological, descriptive, and longitudinal study using secondary data from national information systems on notifiable diseases, births, deaths, COVID-19, HIV, malaria, occupational diseases, and other communicable diseases. A total of 43 data sources were analyzed, covering the period from 2010 to 2023 at the national level. Proportions of completed race/ethnicity records were calculated, and temporal trends were assessed across systems and for the country.

RESULTS:
A progressive improvement in the completeness of race/ethnicity data was observed over the study period, with more pronounced advances in the second half of the time series. Nevertheless, substantial levels of missing information persist, with marked variability across information systems, particularly for dengue, COVID-19, rubella, varicella, and work-related health conditions. These findings suggest that, despite institutional and regulatory advances, data quality remains insufficient to fully support robust analyses of racial health equity.

CONCLUSIONS:
Incomplete race/ethnicity data remain a significant barrier to monitoring racial health inequalities in Brazil. Strengthening data governance, professional training, and institutional accountability is crucial to ensure that health information systems fulfill their strategic role in addressing structural racism and promoting health equity.