Department of Epidemiology and Public Health, University College London, London, UK.
Graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Brazil.
Community Dent Oral Epidemiol. 2020 Aug;48(4):302-308. doi: 10.1111/cdoe.12533. Epub 2020 Apr 1.
To investigate differences between Pardos (mixed) and Blacks with their White counterparts in the use of public dental service among a sample of Brazilian adults taking into consideration the role of individual and contextual characteristics.
A total of 6196 adults aged 35-44 years were sampled from the 2010 Brazilian National Oral Health Survey and nested in one of 27 Brazilian State Capitals. Binary multilevel logistic analyses were conducted. Use of public dental service in the last visit was the outcome, and self-reported colour/race (Pardo, Black, White) was the explanatory variable. Individual covariates were sex, level of education, family income, self-reported need for treatment, dental pain in the last 6 months, presence of decayed, filled and missing teeth. The State Capital covariates were proportion of Pardos/Blacks, Human Development Index, Gini coefficient, Integration of dental teams into Brazil Family Health Program and dentist per population rate.
Pardos and Blacks were 1.25 (95% CI 1.10-1.42) and 1.73 (95% CI 1.41-2.11) times, respectively, more likely to visit the public dental service than Whites. Adjustments for level of education and income were more relevant in affecting the estimates between groups than any other covariate, but differences persisted. Colour/race was independently associated with the type of service used in the last dental visit after fully adjusted for individual and State Capital characteristics.
Racial differences in dental service utilization were evident for middle-aged adults in Brazil. The results found highlight the importance of investments in public dental service as Pardos and Blacks relied more on this type of service than Whites.
在考虑个体和背景特征的作用下，调查巴西成年人样本中 Pardos（混血儿）和黑人与白人在使用公共牙科服务方面的差异。
2010 年巴西国家口腔健康调查中抽取了 6196 名 35-44 岁的成年人，并将其嵌套在巴西 27 个首府城市之一中。采用二元多层逻辑分析。上一次就诊时使用公共牙科服务是结果，自我报告的肤色/种族（Pardo、Black、White）是解释变量。个体协变量为性别、教育水平、家庭收入、自我报告的治疗需求、过去 6 个月的牙痛、龋齿、填充和缺失牙齿的存在。首府城市的协变量包括 Pardos/Blacks 的比例、人类发展指数、基尼系数、牙科团队整合到巴西家庭健康计划以及牙医与人口比率。
Pardo 和黑人分别是白人的 1.25 倍（95%可信区间 1.10-1.42）和 1.73 倍（95%可信区间 1.41-2.11），更有可能使用公共牙科服务。与任何其他协变量相比，调整教育和收入水平对估计组间差异更为重要，但差异仍然存在。在充分调整个体和首府城市特征后，肤色/种族与上一次牙科就诊时使用的服务类型独立相关。
巴西中年成年人在牙科服务利用方面存在种族差异。研究结果强调了投资公共牙科服务的重要性，因为 Pardos 和黑人比白人更依赖这种类型的服务。
