Inequalities in the use of dental services by people with and without disabilities in Brazil: a National Health Survey.

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Clinical Oral Investigations Pub Date : 2024-09-21 DOI:10.1007/s00784-024-05917-7

Francine Dos Santos Costa, Luany Possebom Dos Santos, Luiz Alexandre Chisini

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Abstract

Objectives: The present cross-sectional study aimed to evaluate if social, racial, and gender inequalities disproportionally affect the use of dental services by people with and without disabilities in Brazil in the year 2013.

Materials and methods: The study used data from the 2013 National Health Survey and the dependent variable was the use of dental services. The outcome was stratified by gender, race, and social variables. Descriptive analysis was represented by absolute and relative frequencies. Two inequality measures were used to investigate the inequalities: the Slope Index of Inequalities (SII) and the Concentration Index of Inequalities (CIX). The SII expresses the absolute difference and the CIX identifies the relative inequality.

Results: Of 145,580 adults evaluated, 7.7% reported disability. The proportion of adults without disabilities who used dental services in the last 12 months was higher (45.2%; 95%CI 44.2-46.1) than adults with disabilities (33.9%; 95%CI 32.0-35.9). There was an absolute difference of 40% points (SII 0.40; CI95% (0.36-0.45) in the use of dental services between poorer and richer people with disabilities. Absolute and relative inequalities were identified in the use of dental services, considering the education of the head of the family and family income, with similar results for people with and without disabilities. High inequality is observed concerning race. Racial minorities (Black, Brown, Yellow, and Indigenous) without disabilities presented a higher use of dental services in the last 12 months than racial minorities with disabilities.

Conclusions: Our findings demonstrate that social and racial inequities negatively affect individuals with and without disabilities.

Clinical relevance: Inequalities exist in the use of oral health services for people with and without disabilities.

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巴西残疾人和非残疾人使用牙科服务的不平等现象：全国健康调查。

研究目的本横断面研究旨在评估社会、种族和性别不平等是否会对2013年巴西残疾人和非残疾人使用牙科服务造成不成比例的影响：研究使用了 2013 年全国健康调查的数据，因变量为牙科服务的使用情况。研究结果按性别、种族和社会变量进行了分层。描述性分析以绝对频率和相对频率表示。调查中使用了两种不平等测量方法：不平等斜率指数（SII）和不平等集中指数（CIX）。SII 表示绝对差异，CIX 表示相对不平等：在接受评估的 145 580 名成年人中，有 7.7% 报告患有残疾。在过去 12 个月中使用过牙科服务的非残疾成年人比例（45.2%；95%CI 44.2-46.1）高于残疾成年人（33.9%；95%CI 32.0-35.9）。在使用牙科服务方面，较贫穷和较富有的残疾人之间存在 40% 的绝对差异（SII 0.40；CI95% (0.36-0.45)）。考虑到户主的教育程度和家庭收入，在使用牙科服务方面发现了绝对和相对的不平等，残疾人和非残疾人的结果相似。在种族方面存在严重的不平等。在过去 12 个月中，非残疾少数种族（黑人、棕色人种、黄种人和土著人）使用牙科服务的比例高于残疾少数种族：我们的研究结果表明，社会和种族不平等对残疾人和非残疾人都有负面影响：临床相关性：残疾人和非残疾人在使用口腔健康服务方面存在不平等。

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来源期刊

Clinical Oral Investigations 医学-牙科与口腔外科

CiteScore

6.30

自引率

5.90%

发文量

484

审稿时长

3 months

期刊介绍： The journal Clinical Oral Investigations is a multidisciplinary, international forum for publication of research from all fields of oral medicine. The journal publishes original scientific articles and invited reviews which provide up-to-date results of basic and clinical studies in oral and maxillofacial science and medicine. The aim is to clarify the relevance of new results to modern practice, for an international readership. Coverage includes maxillofacial and oral surgery, prosthetics and restorative dentistry, operative dentistry, endodontics, periodontology, orthodontics, dental materials science, clinical trials, epidemiology, pedodontics, oral implant, preventive dentistiry, oral pathology, oral basic sciences and more.