IADR Abstract Archives
Associations between area-level socioeconomic indicators and public dental services in Southern Brazil
Objectives: To test associations between municipal socioeconomic indicators and the outcomes of public dental services in the state of Santa Catarina, Southern Brazil.
Methods: A secondary analysis of data from 293 municipal dental health services records from 2010 to 2015 was conducted. Outcomes of dental services included proportion of public dental health coverage, proportion of tooth extraction among all clinical procedures and monthly participation in supervised tooth brushing. Multivariable log-binomial regression models were fitted to test associations between tertiles of municipal Human Development Index (HDI) and dichotomized outcomes based on state goals for oral health services: proportion of public coverage (cut off point of 65%) proportion of tooth extraction (cut off point of 4%), and mean of supervised tooth brushing (cut of point of 3%). Models were adjusted for year, age, sex, proportion of rural residents, population size and fluoridated water supply.
Results: Adjusted analyses showed that municipalities with the lowest tertile of HDI had 66% lower prevalence of having public dental health coverage less than 66% (95%CI: 0.24, 0.50) than those with the highest tertile of HDI. However, municipalities with the lowest tertile of HDI had 30% (95%CI: 1.20, 1.40) higher prevalence of having proportion of extraction more than 4% than those in the highest tertile of HDI. Similarly, the municipalities with the lowest tertile of HDI had 34% (95%CI 1.23, 1.45) higher prevalence of not achieving the goals for supervised tooth-brushing than the municipalities in highest HDI
Conclusions: Municipal HDI was found to be associated with outcomes of public dental services. However, the associations were in opposite directions for proportion of public dental coverage and other outcomes. The municipal socioeconomic status was negatively associated with proportion of public dental coverage. Nevertheless, it was positively associated with the proportion of tooth extraction and supervised tooth-brushing. Mixed findings point towards the need to probe equity in planning of public dental services.
Methods: A secondary analysis of data from 293 municipal dental health services records from 2010 to 2015 was conducted. Outcomes of dental services included proportion of public dental health coverage, proportion of tooth extraction among all clinical procedures and monthly participation in supervised tooth brushing. Multivariable log-binomial regression models were fitted to test associations between tertiles of municipal Human Development Index (HDI) and dichotomized outcomes based on state goals for oral health services: proportion of public coverage (cut off point of 65%) proportion of tooth extraction (cut off point of 4%), and mean of supervised tooth brushing (cut of point of 3%). Models were adjusted for year, age, sex, proportion of rural residents, population size and fluoridated water supply.
Results: Adjusted analyses showed that municipalities with the lowest tertile of HDI had 66% lower prevalence of having public dental health coverage less than 66% (95%CI: 0.24, 0.50) than those with the highest tertile of HDI. However, municipalities with the lowest tertile of HDI had 30% (95%CI: 1.20, 1.40) higher prevalence of having proportion of extraction more than 4% than those in the highest tertile of HDI. Similarly, the municipalities with the lowest tertile of HDI had 34% (95%CI 1.23, 1.45) higher prevalence of not achieving the goals for supervised tooth-brushing than the municipalities in highest HDI
Conclusions: Municipal HDI was found to be associated with outcomes of public dental services. However, the associations were in opposite directions for proportion of public dental coverage and other outcomes. The municipal socioeconomic status was negatively associated with proportion of public dental coverage. Nevertheless, it was positively associated with the proportion of tooth extraction and supervised tooth-brushing. Mixed findings point towards the need to probe equity in planning of public dental services.