Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Postgraduate Program in Community Health, Federal University of Santa Catarina, Florianópolis, Brazil.
Community Dent Oral Epidemiol. 2018 Feb;46(1):24-29. doi: 10.1111/cdoe.12324. Epub 2017 Jul 24.
To explore factors associated with discrimination in healthcare services and to assess whether discrimination based on dental aesthetics differs by sex.
Cross-sectional analysis based on a household survey carried out in a city in Southern Brazil. Fifteen primary health care (PHC) units with a dental team were randomly selected, and individuals who used the public services in the catchment areas of the PHC units were interviewed. The survey questionnaire included experiences with discrimination related to health services, sociodemographic and dental characteristics. Multiple logistic regressions were estimated with dental appearance as outcome.
The final sample was composed of 433 individuals, with 15.2% reporting being discriminated in health services. Participants with ≥20 teeth were significantly more likely to report discrimination than those with <20 teeth (16.6% vs 9.1%, respectively), and people with twisted and stained teeth reported more discrimination than those with white and aligned teeth (23.2% vs 9.9%, respectively). Overall, individuals with twisted and stained teeth were more likely to report discrimination (OR=3.13; 95% CI: 1.46-6.71). When the analyses were stratified by sex, women with twisted and stained teeth showed an OR=3.62 (95% CI: 1.55-8.46) and men OR=0.54 (95% CI: 0.05-6.18).
Dental appearance may lead to discrimination in healthcare services, but this seems to be more important for women than men.
探讨与医疗服务歧视相关的因素，并评估基于牙齿美观的歧视是否存在性别差异。
基于巴西南部某市进行的一项家庭调查进行的横断面分析。随机选择了 15 个拥有牙科团队的初级卫生保健 (PHC) 单位，并对 PHC 单位服务覆盖范围内使用公共服务的个人进行了访谈。调查问卷包括与卫生服务相关的歧视经历、社会人口学和牙科特征。以牙齿外观为结果进行多因素逻辑回归分析。
最终样本由 433 人组成，15.2%的人报告在医疗服务中受到歧视。拥有≥20 颗牙齿的参与者报告歧视的可能性明显高于拥有<20 颗牙齿的参与者（分别为 16.6%和 9.1%），牙齿扭曲和着色的参与者报告歧视的可能性高于牙齿洁白整齐的参与者（分别为 23.2%和 9.9%）。总的来说，牙齿扭曲和着色的人更有可能报告受到歧视（OR=3.13；95%CI：1.46-6.71）。当按性别分层分析时，牙齿扭曲和着色的女性报告的 OR=3.62（95%CI：1.55-8.46），而男性 OR=0.54（95%CI：0.05-6.18）。
牙齿外观可能导致医疗服务中的歧视，但这种歧视对女性似乎比对男性更重要。
