Social inequalities in indicators of use of healthcare services by adolescents in Campinas, São Paulo, Brazil

Abstract

This study aimed to analyze the prevalence of indicators of use of healthcare services according to sex, income and race/skin color, in adolescents (aged 10-19 years old) based on data from the Health Survey of the Municipality of Campinas (ISACamp), carried out in 2014/2015 in Campinas, São Paulo, Brazil. The chi-square test was used to evaluate the differences between the outcome variables (indicators of use of healthcare service) and sex, income and race/skin color. Adjusted prevalence ratios (PR) were estimated using Poisson multiple regression models. The demand for medical care was high in the last year of the interview (79.2%), mostly attended by the Brazilian Unified National Health System (65.2%), with routine consultations being more prevalent for females (PR = 1.17; 95%CI: 1.01-1.34) and injury for the male population (PR = 0.47; 95%CI: 0.26-0.84). Economic and racial differences were found in the evaluation of the last medical consultation, with a higher prevalence of worse care among those with lower income (PR = 1.46; 95%CI: 1.14-1.87) and black people (PR = 1.27; 95%CI: 1.01-1.61). Inequalities remained for delay or failure to carry out exams (PR = 1.64; 95%CI: 1.02-2.64) and worse quality of dental care (PR = 2.10; 95%CI: 1.38-3.21) in those with lower income. Also, black people had fewer appointments with dentists (PR = 0.90; 95%CI: 0.82-0.99).