Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2016

Open Access 01-12-2016 | Research article

Socioeconomic inequalities in dental health services in Sao Paulo, Brazil, 2003–2008

Authors: Camila Nascimento Monteiro, Mariëlle A. Beenackers, Moisés Goldbaum, Marilisa Berti de Azevedo Barros, Reinaldo José Gianini, Chester Luiz Galvão Cesar, Johan P. Mackenbach

Published in: BMC Health Services Research | Issue 1/2016

Login to get access

Abstract

Background

Access to, and use of, dental health services in Brazil have improved since 2003. The increase of private health care plans and the implementation of the “Smiling Brazil” Program, the largest public oral health care program in the world, could have influenced this increase in access. However, we do not yet know if inequalities in the use of dental health services persist after the improvement in access. The aims of this study are to analyze socioeconomic differences for dental health service use between 2003 and 2008 in São Paulo and to examine changes in these associations since the implementation of the Smiling Brazil program in 2003.

Method

Data was obtained via two household health surveys (ISA-Capital 2003 and ISA-Capital 2008) which investigated living conditions, lifestyle, health status and use of health care services. Logistic regression was used to analyze associations between socioeconomic factors and dental services use. Additionally, trends from 2003 to 2008 regarding socioeconomic characteristics and dental health service use were explored.

Results

Overall, dental health service use increased between 2003 and 2008 and was at both time points more common among those who had higher income, better education, better housing conditions, private health care plans and were Caucasian. Inequalities in use of dental health care did not decrease over time. Among the reasons for not seeking dental care, not having teeth and financial difficulty were more common in lower socioeconomic groups, while thinking it was unnecessary was more common in higher socioeconomic groups.

Conclusions

The Brazilian oral health policy is still in a period of expansion and seems to have contributed slightly to increased dental health service use, but has not influenced socioeconomic inequalities in the use of these services. Acquiring deeper knowledge about inequalities in dental health service use will contribute to better understanding of potential barriers to reducing them.
Appendix
Available only for authorised users
Footnotes
Literature
1.
Paim J, Travassos C, Almeida C, Bahia L, Macinko J. The Brazilian health system: history, advances, and challenges. Lancet. 2011;377:11–31.CrossRef
2.
Manfredini MA, Moysés SJ, Noro LRA, Narvai PC. Private and public dental care in the city of São Paulo in the first decade of the XXI century. Saúde soc. 2012;21(2):323–35.
3.
Machado CV, Baptista TWF, Nogueira CO. Health policies in Brazil in the 2000s: the national priority agenda. Cad saude publica. 2011;27(3):521–32.CrossRefPubMed
4.
5.
Soares CLM. Constructing public oral health policies in Brazil: issues for reflection. Braz oral res. 2012;26(1):94–102.CrossRefPubMed
6.
Navarro MFL, Modena KCS, Bresciani E. Social disparity and oral health. Braz oral res. 2012;26(1):17–24.CrossRefPubMed
7.
Pucca Junior GA, Costa JFR, Chagas LD, Silvestre RM. Oral health policies in Brazil. Braz oral res. 2009;23(Spec Iss 1):9–16.
8.
9.
10.
11.
12.
Travassos C. Equity in the Brazilian health care system: a contribution for debate. Cad saude publica. 1997;13(2):325–30.CrossRefPubMed
13.
Victora CG, Matijasevich A, Silveira M, Santos I, Barros AJ, Barros FC. Socio-economic and ethnic group inequities in antenatal care quality in the public and private sector in Brazil. Health policy plan. 2010;25(4):253–61.CrossRefPubMedPubMedCentral
14.
Mcgrath C, Bedi R, Dhawan N. Factors influencing older people’s self reported use of dental services in the UK. Gerodontology. 1999;16:97–102.CrossRefPubMed
15.
Wallace BB, MacEntee MI. Access to dental visit for Low-income adults: perceptions of affordability, availability and acceptability. J community health. 2012;37:32–9.CrossRefPubMed
16.
Alves MCGP, Escuder MML. Plano de amostragem. [sampling plan]. In: Cesar CLG, Carandina L, Alves MCGP, Barros MBA, Goldbaum M, editors. Saúde e condição de vida em São Paulo [health and life status in São Paulo-Brazil]. São Paulo: USP/FSP; 2005. p. 38–52.
17.
18.
Brazilian Institute of Geography and Statistics. [Instituto Brasileiro de Geografia e Estatística-IBGE]. Census 2000. Characteristics of the population and households. SEADE. 2000. Available from: http://​www.​ibge.​gov.​br/​. Accessed in 10 Oct 2014.
19.
20.
Batista LE, Escuder MML, Rodrigues JC. The color of death: causes of death according to race in the state of Sao Paulo, 1999 to 2001. Rev saude publica. 2004;38(5):1–6.CrossRef
21.
Matos DL, Giatti L, Lima-Costa MF. Socio-demographic factors associated with dental services among Brazilian older adults: a study based on the national household sample survey. Cad saude publica. 2004;20(5):1290–7.CrossRefPubMed
22.
Bhandari B, Newton JT, Bernabé E. Income inequality, disinvestment in health care and use of dental services. J public health dent. 2015;75(1):58–63.CrossRefPubMed
23.
Silva ZP, Ribeiro MCSA, Barata RB, Almeida MF. Socio-demographic profile and use patterns of the public healthcare system (SUS), 2003–2008. Ciên saúde colet. 2011;16(9):3807–16.CrossRefPubMed
24.
Palència L, Espelt A, Cornejo-Ovalle M, Borrell C. Socioeconomic inequalities in the use of dental care services in Europe: what is the role of public coverage? Community dent oral epidemiol. 2014;42:97–105.CrossRefPubMed
25.
Colussi CF, Freitas SFT. Aspectos epidemiológicos da saúde bucal do idoso no Brasil. Cad saude publica. 2002;18:1313–20.CrossRefPubMed
26.
Bernabé E, Sheiham A. Tooth loss in the United Kingdom—trends in social inequalities: an age-period-and-cohort analysis. Plos one. 2014;9(8):e104808.CrossRefPubMedPubMedCentral
27.
Elani HW, Harper S, Allison PJ, Bedos C, Kaufman JS. Socio-economic inequalities and oral health in Canada and the United States. J dent res. 2012;91:865–70.CrossRefPubMed
28.
Cesar CLG, Navai PC, Gatas VL, Figueiredo GM. Fear of the dentist and demanding for dental care in cities of west area of São Paulo metropolitan region. Odontologia e sociedade. 1999;1:39–44.
29.
Antunes JLF, Narvai PC. Dental health policies in Brazil and their impact on health inequalities. Rev saude publica. 2010;44(2):2–6.
30.
31.
Scherer CI, Scherer MDA. Advances and challenges in oral health after a decade of the “smiling Brazil” program. Rev saude publica. 2015;49:98.CrossRef
32.
Soares CLM, Paim JS. Critical issues for implementing oral health policy in the city of Salvador, Bahia state, Brazil. Cad saude publica. 2011;27(5):966–74.CrossRefPubMed
Metadata
Title
Socioeconomic inequalities in dental health services in Sao Paulo, Brazil, 2003–2008
Authors
Camila Nascimento Monteiro
Mariëlle A. Beenackers
Moisés Goldbaum
Marilisa Berti de Azevedo Barros
Reinaldo José Gianini
Chester Luiz Galvão Cesar
Johan P. Mackenbach
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1928-y

Other articles of this Issue 1/2016

BMC Health Services Research 1/2016 Go to the issue

Research article

Assessing the disparity in spatial access to hospital care in ethnic minority region in Sichuan Province, China

Research article

Justifications for coercive care in child and adolescent psychiatry, a content analysis of medical documentation in Sweden

Research article

Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example

Research article

Investigating the feasibility, acceptability and appropriateness of outreach case management in an urban Aboriginal and Torres Strait Islander primary health care service: a mixed methods exploratory study

Research article

Development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making

Research article

Somatic healthcare utilisation patterns among older people with intellectual disability: an 11-year register study