Bueno Roberto Eduardo, Moysés Simone Tetu, Bueno Paula Alexandra Reis, Moysés Samuel Jorge
Escola de Saúde e Biociências, Pontifícia Universidade Católica do Paraná, ,
Faculdade de Educação, Universidade de São Paulo.
Rev Panam Salud Publica. 2014 Jul;36(1):17-23.
To assess the correlation between the social determinants of oral health (SDOH) index and social indicators, indicators of oral health, and intermediary social determinants expressed by the indicators of the Government of Brazil's National Oral Health Policy.
This ecological study included 5 915 adults aged 35 to 44 years from 27 Brazilian capitals. Indicators of oral health outcomes-tooth loss, restored teeth, and dental care index (DCI)-were extracted from the 2010 National Oral Health Survey. Social indicators (structural social determinants) and indicators of the National Oral Health Policy were obtained from census data and from the Ministry of Health.
A moderate Pearson correlation (r) was observed between SDOH and DCI (r = 0.580), restored teeth (r = 0.545), and tooth loss (r = - 0.490). The social equity component was strongly correlated to DCI (r = 0.856), restored teeth (r = 0.822), and tooth loss (r = - 0.665). These oral health outcomes were not statistically associated with the components related to primary and secondary oral health care. The social equity component explained 44% of the variance in tooth loss, 68% of the variance in the number of restored teeth, and 73% of the variance in DCI.
A significant correlation was observed between SDOH and the social equity component with oral health outcomes in adults in Brazilian capitals. Therefore, equity policies should prioritize actions focused on the SDOH, such as increased sanitation coverage and water fluoridation, and on reducing poverty and regional inequities.
评估口腔健康社会决定因素（SDOH）指数与社会指标、口腔健康指标以及巴西国家口腔健康政策指标所表达的中介社会决定因素之间的相关性。
这项生态学研究纳入了来自巴西27个首府的5915名35至44岁的成年人。口腔健康结果指标——牙齿缺失、补牙情况和牙科护理指数（DCI）——取自2010年全国口腔健康调查。社会指标（结构性社会决定因素）和国家口腔健康政策指标来自人口普查数据和卫生部。
观察到SDOH与DCI（r = 0.580）、补牙情况（r = 0.545）和牙齿缺失（r = - 0.490）之间存在中等程度的皮尔逊相关性。社会公平成分与DCI（r = 0.856）、补牙情况（r = 0.822）和牙齿缺失（r = - 0.665）密切相关。这些口腔健康结果与初级和二级口腔保健相关成分无统计学关联。社会公平成分解释了牙齿缺失变异的44%、补牙数量变异的68%和DCI变异的73%。
在巴西首府的成年人中，观察到SDOH及社会公平成分与口腔健康结果之间存在显著相关性。因此，公平政策应优先采取关注SDOH的行动，如提高卫生设施覆盖率和水氟化，以及减少贫困和地区不平等。
