Iniquidades raciais em saúde bucal no Brasil

Guiotoku, Sandra Katsue; Moysés, Simone Tetü; Moysés, Samuel Jorge; França, Beatriz Helena Sottile; Bisinelli, Júlio C.

doi:10.1590/s1020-49892012000200007

Cited by 67 publications

(72 citation statements)

References 24 publications

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“…These racial inequalities have also been previously identified in oral healthcare services. The use of public healthcare services was different among dark-skinned blacks (56.8%), light-skinned blacks (53.3%), and whites (41.6%) [47], as was also verified in the present study. In the United States, results have also shown that the dark-skinned black population more commonly seeks out public healthcare services, while the white population more often uses private healthcare services, data which has remained unchanged over time [48,49].…”

Section: Discussionsupporting

confidence: 83%

“…In Brazil, even with its universal healthcare system [56], the same barriers relevant to individual income and, consequently, to the payment of healthcare services can be found [25-30,35,47,52,57,58]. The present study, therefore, identified a dose–response gradient for this variable, which reinforces its determination in the use of public healthcare services.…”

Section: Discussionsupporting

confidence: 69%

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Comparing adult users of public and private dental services in the state of Minas Gerais, Brazil

2014

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BackgroundStudying the factors associated with the use of dental services can provide the necessary knowledge to understand the reasons why individuals seek out public healthcare services and the formulation of more appropriate public policies for the present-day reality.MethodsThis work was a cross-sectional epidemiological study consisting of a sample of adults found in a research databank concerning the conditions of the oral health of the population of the state of Minas Gerais, Brazil. This study examined both main oral health disorders and relevant socioeconomic aspects. The dependent variable was defined as the type of service used, categorized under public and private use. The independent variables were selected and grouped to be inserted in the analysis model according to an adaptation of the behavioral model described by Andersen and Davidson. A hierarchical model was used to analyze the data. The description of variables and bivariate analyses were performed in an attempt to verify possible associations. For each group of variables at each hierarchical level, the gross and adjusted odds ratios (OR) and the respective 95% confidence intervals (CI) were estimated by means of logistic regression. The Complex Samples model from the SPSS statistics program, version 19.0, was used to analyze the sample framework.ResultsIn the final model, the factors associated with the use of public healthcare services by adults were directly related to the socioeconomic and demographic conditions of the individuals, including: being of a dark-skinned black race/color, belonging to families with more than four household residents and with a lower income level, residing in small towns, having more teeth that need treatment.ConclusionsAccording to the findings from this study, socioeconomic and demographic factors, as well as normative treatment needs, are associated with the use of public dental services.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 69%

Comparing adult users of public and private dental services in the state of Minas Gerais, Brazil

2014

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“…All of the studies were published between 1975 and 2016 [21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81]. Twenty new studies were included in this update [26,27,28,29,31,38,39,40,44,45,…”

Section: Resultsmentioning

confidence: 99%

“…Twenty new studies were included in this update [26,27,28,29,31,38,39,40,44,45,47,49,50,53,59,61,66,67,79,81]. The language was predominantly English (96.7%).…”

Section: Resultsmentioning

confidence: 99%

Socioeconomic Factors and Caries in People between 19 and 60 Years of Age: An Update of a Systematic Review and Meta-Analysis of Observational Studies

Costa

Martins

Pinto

et al. 2018

IJERPH

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This study is aimed to perform an update of a systematic review and meta-regression to evaluate the effect modification of the socioeconomic indicators on caries in adults. We included studies that associated social determinants with caries, with no restriction of year and language. The Newcastle-Ottawa Scale was used to evaluate the risk of bias. With regard to the meta-analysis, statistical heterogeneity was evaluated by I2, and the random effect model was used when it was high. A subgroup analysis was conducted for socioeconomic indicators, and a meta-regression was performed. Publication bias was assessed through Egger’s test. Sixty-one studies were included in the systematic review and 25 were included in the meta-analysis. All of the studies were published between 1975 and 2016. The most frequent socioeconomic indicators were schooling, income, and socioeconomic status (SES). In the quantitative analysis, the DMFT (decayed, missing, filled teeth) variation was attributed to the studies’ heterogeneity. The increase of 10.35 units in the proportion of people with lower SES was associated with an increase of one unit in DMFT, p = 0.050. The findings provide evidence that populations with the highest proportions of people with low SES are associated with a greater severity of caries. The results suggest the need for actions to reduce the inequalities in oral health (PROSPERO [CRD42017074434]).

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“…Many countries have been trying to increase the accessibility to health care resources and provide better healthcare services for their people. Studies regarding the health inequality issue have found influences of racial/ethnic [1-3], socioeconomic [4,5] and geographic [6-8] factors on health status (e.g., disease status [5,9] or mortality [10,11]), healthcare resources utilization [8,12,13], and outcomes (e.g., postoperative mortality rates [14]). Most of the results from these studies have pointed to positive relationships between the indicators of social status and various health outcomes [15-17].…”

Section: Introductionmentioning

confidence: 99%

Do low-income coronary artery bypass surgery patients have equal opportunity to access excellent quality of care and enjoy good outcome in Taiwan?

Hou

Chung

2014

Int J Equity Health

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BackgroundEquity is an important issue in the healthcare research field. Many studies have focused on the relationship between patient characteristics and outcomes of care. These studies, however, have seldom examined whether patients’ characteristics affected their access to quality healthcare, which further affected the care outcome. The purposes of this study were to determine whether low-income coronary artery bypass surgery (CABG) patients receive healthcare services with poorer quality, and if such differences in treatment result in different outcomes.MethodsA retrospective multilevel study design was conducted using claims data from Taiwan’s universal health insurance scheme for 2005-2008. Patients who underwent their CABG surgery between 2006 and 2008 were included in this study. CABG patients who were under 18 years of age or had unknown gender or insured classifications were excluded. Hospital and surgeon’s performance indicators in the previous one year were used to evaluate the level of quality via k-means clustering algorithm. Baron and Kenny’s procedures for mediation effect were conducted to explore the relationship among patient’s income, quality of CABG care, and inpatient mortality.ResultsA total of 10,320 patients were included in the study. The results showed that 5.65% of the low-income patients received excellent quality of care, which was lower than that of patients not in the low-income group (5.65% vs.11.48%). The mortality rate of low-income patients (12.10%) was also higher than patients not in the low-income group (5.25%). Also, the mortality of patients who received excellent care was half as low as patients receiving non-excellent care (2.63% vs. 5.68%). Finally, after the procedure of mediation effect testing, the results showed that the relationship between patient income level and CABG mortality was partially mediated by patterns of quality of care.ConclusionsThe results of the current study implied that worse outcome in low-income CABG patients might be associated with poorer quality of received services. Health authorities should pay attention to this issue, and propose appropriate solutions.

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Iniquidades raciais em saúde bucal no Brasil

Cited by 67 publications

References 24 publications

Comparing adult users of public and private dental services in the state of Minas Gerais, Brazil

Comparing adult users of public and private dental services in the state of Minas Gerais, Brazil

Socioeconomic Factors and Caries in People between 19 and 60 Years of Age: An Update of a Systematic Review and Meta-Analysis of Observational Studies

Do low-income coronary artery bypass surgery patients have equal opportunity to access excellent quality of care and enjoy good outcome in Taiwan?

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