Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Brazil.
Scand J Public Health. 2011 Aug;39(6):640-8. doi: 10.1177/1403494811414246. Epub 2011 Jul 5.
To describe trends in socioeconomic disparities in utilization of dental care.
We obtained cross-sectional data from Sweden in the period 1968-2000 and from Brazil in 1986 and 2002 for 16 state capitals. The outcome was the percentage of people who reported that they had visited the dentist in the last 12 months, calculated for a higher and a lower income group and stratified by sex, age (two groups: young and adults) and dental status. Adjusted prevalence differences and prevalence ratios were produced using Poisson regression.
In Brazil, there was a decline in use of dental care among the 15-19 year olds in the period 1986-2002, but not among the 35-44 year olds. In Sweden, there was a decline among the young and adults between 1991 and 2000. Overall, socioeconomic disparities in use of dental services between the higher and the lower economic groups showed a decline in both countries. The reduction in disparities among young Brazilians was 1.1 percentage points per year (p < 0.01), but among the other age groups the decline was not significant (p>0.01). In the last surveys, the gap remained in both countries and age groups (p < 0.01).
The recent decline in utilization of dental care and in the socioeconomic gap may mirror improvements in oral health. However, there are still relevant and persistent disparities in utilization of dental care in both countries, with a higher proportion of people of higher socioeconomic status visiting the dentist.
描述牙科保健利用方面的社会经济差异的变化趋势。
我们获取了瑞典在 1968-2000 年以及巴西在 1986 年和 2002 年 16 个州府的横断面数据。结果为报告过去 12 个月内看牙医的人数比例，根据收入较高和较低两个组进行计算，并按性别、年龄（青年和成年人两个组）和牙齿状况进行分层。使用泊松回归分析产生调整后流行率差异和流行率比。
在巴西，1986-2002 年间，15-19 岁青少年的牙科保健利用率下降，但 35-44 岁人群没有变化。在瑞典，1991-2000 年间，青年人和成年人的利用率都下降了。总的来说，巴西和瑞典两国的牙科服务利用方面的社会经济差异呈现出下降趋势。两国年轻人之间的差异减少了每年 1.1 个百分点（p < 0.01），但其他年龄组的差异不显著（p>0.01）。在最近的调查中，两国和各年龄组之间的差距仍然存在（p < 0.01）。
最近牙科保健利用率和社会经济差距的下降可能反映出口腔健康的改善。然而，在这两个国家，牙科保健的利用仍然存在明显且持续的差异，社会经济地位较高的人群看牙医的比例更高。
