Aurélio Peres Marco, Simara Fernandes Liliane, Glazer Peres Karen
Department of Public Health, Federal University of Santa Catarina, Campus Universitário, Florianópolis, Santa Catarina 88010-970, Brazil.
Soc Sci Med. 2004 Mar;58(6):1181-9. doi: 10.1016/s0277-9536(03)00289-2.
The purpose of this ecological study was to investigate the association between social and economic indicators at the municipal level and the presence of water fluoridation and time when water fluoridation was implemented in the 293 municipalities of Santa Catarina State in Southern Brazil. Several social and economic indicators were obtained from official Brazilian agencies as well as from UNICEF. Questionnaires were sent to local authorities and to the local government water supply Company to obtain information about the presence or not of a fluoridated water supply and the year when fluoridation was implemented. Differences in social and economic indicators between municipalities with and without fluoridated water and between those that have had this service for different lengths of time were compared by the Mann-Whitney U test. In addition, multiple logistic regression analyses was performed to identify associations between social and economic indicators at the municipal level and presence and time of implementation of water fluoridation. Results indicated that larger populations are associated with municipalities with fluoridated water. Larger populations, higher child development indexes and low illiteracy rates are associated with a longer time since the implementation of water fluoridation. The finding that less developed municipalities delayed the provision of water fluoridation corroborates the inverse equity hypothesis.
这项生态研究的目的是调查巴西南部圣卡塔琳娜州293个市的社会经济指标与水氟化的存在情况以及实施水氟化的时间之间的关联。若干社会经济指标来自巴西官方机构以及联合国儿童基金会。向地方当局和当地政府供水公司发送了调查问卷，以获取有关是否存在氟化供水以及实施氟化的年份的信息。通过曼-惠特尼U检验比较了有氟化水和没有氟化水的市之间以及使用该服务时间不同的市之间社会经济指标的差异。此外，进行了多元逻辑回归分析，以确定市一级的社会经济指标与水氟化的存在情况及实施时间之间的关联。结果表明，人口较多与有氟化水的市相关。人口较多、儿童发展指数较高和文盲率较低与实施水氟化后的时间较长相关。欠发达市推迟提供水氟化这一发现证实了反向公平假说。
