Perceived discrimination in health services and preventive dental attendance in Brazilian adults

Abstract

Objectives It is evident that discriminatory attitudes affect different dimensions of personal life, including health. This study aimed to verify the association between perceived discrimination in health services and preventive dental attendance in Brazilian adults. Methods This cross‐sectional study used secondary data from the 2013 National Health Survey (PNS), a representative survey of the Brazilian population. The response rate was 91.9%, with 60,202 adults agreeing to complete the oral health self‐perception questionnaire. Data were analysed using the software STATA 14.0. A descriptive sample analysis was conducted that considered sample weight as well as an association between health discrimination and factors associated with preventive dental attendance through Poisson regression models. Results Adjusted analysis demonstrated that, regarding the reasons that led to discrimination, lack of money, social class and type of working occupation showed a negative association with preventive dental attendance. Conclusion Our findings show that discrimination perpetuates health inequities. Those with worse social conditions need more assistance as they struggle with discrimination and end up going for a check‐up after the disease is established or advanced. Preventive care, which could change the health condition of the disadvantaged population, is often a reality only for those less vulnerable.

Racial and regional inequalities of dental pain in adolescents: Brazilian National Survey of School Health (PeNSE), 2009 to 2015

“…Thus, unequal relationships between social groups shape their distribution to adverse exposures and health conditions. Discrimination in oral health services in Brazil has been highlighted in a recent study 32 and racism has also affected the dentists' decision concerning the replacement of amalgam restorations 33,34 , emphasizing the structural racism that stereotypes and stigmatizes these populations 10 . In this way, it is important to deeply discuss the social-historical roots of Brazilian racism.…”

Conceptualizing inequities and oppression in oral health research

“…One emerging explanation for this association is interpersonal discrimination; however, scholarly work linking discriminatory experiences with oral health is still scant and fragmented. Based on previous reviews 16,25 we identified the publications summarized in Table 1 10,26–45 . All studies have addressed interpersonal discrimination, and only one study tested specific hypotheses based on an intersectional perspective.…”

“…Based on previous reviews 16,25 we identified the publications summarized in Table 1. 10,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] All studies have We argue, then, that the persistence of oral health inequities over time and across space has much to do with how we employ these categories in our scientific, clinical and policy endeavours. 30,46 Understanding oppression in its structural forms requires attention to how the social, political, commercial/corporate and behavioural determinants intersect and impact oral health outcomes.…”

The door is open, but not everyone may enter: racial inequities in healthcare access across three Brazilian surveys

“…Existing evidence also points to prevailing healthcare inequities. Black Brazilians are less likely to have visited the health services recently, have lower health insurance coverage, and are more likely to be mistreated by a health professional [24][25][26][27][28] . Moreover, Black Brazilians are largely concentrated in Northern and Northeastern regions of the country, which are notoriously known for their lower levels of healthcare availability 29 .…”