Social determinants of dental treatment needs in Brazilian adults

Background The chronic cumulative nature of caries makes treatment needs a severe problem in adults. Despite the fact that oral diseases occur in social contexts, there are few studies using multilevel analyses focusing on treatment needs. Thus, considering the importance of context in explaining oral health related inequalities, this study aims to evaluate the social determinants of dental treatment needs in 35–44 year old Brazilian adults, assessing whether inequalities in needs are expressed at individual and contextual levels. Methods The dependent variables were based on the prevalence of normative dental treatment needs in adults: (a) restorative treatment; (b) tooth extraction and (c) prosthetic treatment. The independent variables at first level were household income, formal education level, sex and race. At second level, income, sanitation, infrastructure and house conditions. The city-level variables were the Human Development Index (HDI) and indicators related to health services. Exploratory analysis was performed evaluating the effect of each level through calculating Prevalence Ratios (PR). In addition, a three-level multilevel modelling was constructed for all outcomes to verify the effect of individual characteristics and also the influence of context. Results In relation to the need for restorative treatment, the main factors implicated were related to individual socioeconomic position, however the city-level contextual effect should also be considered. Regarding need for tooth extraction, the contextual effect does not seem to be important and, in relation to the needs for prosthetic treatment, the final model showed effect of individual-level and city-level. Variables related to health services did not show significant effects. Conclusions Dental treatment needs related to primary care (restoration and tooth extraction) and secondary care (prosthesis) were strongly associated with individual socioeconomic position, mainly income and education, in Brazilian adults. In addition to this individual effect, a city-level contextual effect, represented by HDI, was also observed for need for restorations and prosthesis, but not for tooth extractions. These findings have important implications for the health policy especially for financing and planning, since the distribution of oral health resources must consider the inequalities in availability and affordability of dental care for all.

Metabolic syndrome in postmenopausal women: higher prevalence in the Northeastern Region of Brazil than in other Latin American countries and the influence of obesity and socioeconomic factors

SILVEIRA, Inavan Lopes da; MARANHÃO, T. M. O.; AZEVEDO, George Dantas. Metabolic syndrome in postmenopausal women: higher prevalence in the Northeastern Region of Brazil than in other Latin American countries and the influence of obesity and socioeconomic factors. Climacteric (Carnforth), v.10, p.438-439, 2007.

O argumento de inclusão enquanto política de acesso à universidade pública

There are a great number of evidences showing that education is extremely important in many economic and social dimensions. In Brazil, education is a right guaranteed by the Federal Constitution; however, in the Brazilian legislation the right to the three stages of basic education: Kindergarten, Elementary and High School is better promoted and supported than the right to education at College level. According to educational census data (INEP, 2009), 78% of all enrolments in College education are in private schools, while the reverse is found in High School: 84% of all matriculations are in public schools, which shows a contradiction in the admission into the universities. The Brazilian scenario presents that public universities receive mostly students who performed better and were prepared in elementary and high school education in private schools, while private universities attend students who received their basic education in public schools, which are characterized as low quality. These facts have led researchers to raise the possible determinants of student performance on standardized tests, such as the Brazilian Vestibular exam, to guide the development of policies aimed at equal access to College education. Seeking inspiration in North American models of affirmative action policies, some Brazilian public universities have suggested rate policies to enable and facilitate the entry of "minorities" (blacks, pardos1, natives, people of low income and public school students) to free College education. At the Federal University of the state Rio Grande do Norte (UFRN), the first incentives for candidates from public schools emerged in 2006, being improved and widespread during the last 7 years. This study aimed to analyse and discuss the Argument of Inclution (AI) - the affirmative action policy that provides additional scoring for students from public schools. From an extensive database, the Ordinary Least Squares (OLS) technique was used as well as a Quantile Regression considering as control the variables of personal, socioeconomic and educational characteristics of the candidates from the Brazilian Vestibular exam 2010 of the Federal University of the state Rio Grande do Norte (UFRN). The results demonstrate the importance of this incentive system, besides the magnitude of other variables

A relação entre os determinantes sociais em saúde e os investimentos setoriais e a mortalidade infantil em municípios brasileiros com mais de 80 mil habitantes

Investments in health have controversial influence on results of the health of populations, besides being subject rarely explored in literature. Moreover, from the 1970s, the social determinants of health have been consolidated in the disease process as multifactorial factors (social, economic, cultural, etc.) that directly or indirectly influence the occurrence of health problems of populations, as well as mortality rates. This study aimed to evaluate the influence of these investments and the social determinants of health on infant mortality and its neonatal and post-neonatal mortality. This is an ecological study, in which the sample was composed of Brazilians cities with over 80,000 inhabitants, avoiding fluctuations in mortality rates for common small populations, and ensure greater coverage of information systems on mortality and births Brazilians and, therefore, increase data consistency. To isolate the effect of investments in health, we used multiple linear regression. The socioeconomic indicators (p <0.001, p = 0.004, p <0.001), the inequality index (p <0.001, p = 0.001, p = 0.006) and coverage of prenatal visits (p <0.001, p <0.001; p = 0.005) were associated with infant mortality rate total, neonatal and post-neonatal, and the Gross Domestic Product per capita only influenced the overall infant mortality rate and neonatal (p=0.022; 0.045). Investments in health, in this model, lost statistical significance, showing no correlation with mortality rates among children under one year. We conclude that the social determinants of health has an influence on the variation in mortality rates of Brazilian cities, however the same was not observed for indicators of health investment

Fatores socioeconômicos contextuais associados à condição bucal de adolescentes no Brasil

Many surveys are conducted comparing oral health conditions with individual variables, such as socioeconomic and demographic factors. However, in the same way that individuals differ among themselves, the groups also have their own characteristics and the effects of this differentiation must be researched. Brazil, despite being one of the major economic powers of the world and shows an improvement in the average value of its health indicators, is also one of the most unequal and remains among the countries with the greatest health inequities. The purpose of this study was to investigate the importance of social determinants on the contextual level oral health among Brazilian adolescents, population not much researched by the literature. The research was made using an ecological approach in order to identify possible inequalities between cities and capitals. Using data from SBBrasil 2010 it was evaluated less common outcomes (loss of first molar, dental care index and T-Health) which provide information on the degree of morbidity of caries and health level of dental tissues, in addition to analyze the related services. The association of these oral health indicators with socioeconomic factors such as income, employment, education and inequality, collected from Census 2010, was analyzed by simple and multiple linear regressions. The study included the 27 state capitals and four clusters representing the municipalities of the country. It was possible to see better access to services in locations with better income distribution. However, the strong association of contextual factors related to poverty, low levels of education and poor housing and jobs with poorer levels of oral health in adolescents seems to overshadow the effects of income inequalities on dental caries in the country. In some locations, particularly within the North and Northeast, whichever one keeps dentistry mutilating, whose effects are already noticeable in its adolescent population. Access to restorative services in Brazil remains limited and unequal. The results of this study highlight the inequities in oral health in the country and show the need of the inclusion of new perspectives on the traditional approach of Preventive Dentistry and education models in Dentistry. Tackling health inequalities in oral health in the country requires the cooperation of various actors involved in the process and the inclusion of oral health in the context of overall health. The social determinants approach, as well as evaluating the distribution of oral diseases in the country and its inclusion in the context of overall health, should guide the implementation of programs and oral health practices in order to contribute to the reduction of inequalities

Silenciosas e silenciadas: descortinando as violências contra a mulher no cotidiano da prostituição em Natal-RN

The prostitution is known as the world's oldest "profession", according to some historians, "the contemporary civilization itself." However, to refer it that way, we can systematically emptying it of expressions of violence that permeate. Furthermore, this statement tries to legitimize prostitution as a practical historically related to the natural condition of women. The main objective of the research is to examine how the activity prostitucional potentiates in different forms of violence in everyday development of prostitution in the city of Natal. Accordingly, the spot of the categories of gender relations and patriarchal violence against women, refute the thesis advocated by much of feminist studies on of prostitution as an expression of autonomy of women and overcoming the patriarchal order of gender. Procedures as set methodological quali-quantitative approach, guided by the method historicalmaterialist dialectic that allows us to apprehend the object of study beyond their immediate, unmasking its contradictions. We conducted nine interviews with prostitutes belonging to the classes of People who develop the activities in the streets and prostitutes Natals` cabarets. We hand with the systematic observation activities promoted by the Association of Prostitutes in Rio Grande do Norte ASPRORN, as the visits to cabarets, as well as participation in seminars held by this entity, at which establish contacts with informants-c which have facilitated access to interviewed. We note that the economic dimension is the factor determinant for their inclusion in prostitution, all to recognize as who found an alternative for survival, since most do not has no professional training and education. Another issue important to be emphasized concerns the areas where unhealthy develop programs which by itself is characterized as a denial of rights, expressed in the socioeconomic inequality that are subject. As the expressions of violence in their daily lives, the main forms identified were the physical and social, however, there is a trend in naturalizes them, the secondary-over other issues identified as most pressing, such as not service payment by the customers. The determinants of violence identified by respondents were assigned to the woman, or is its boldness. We also, the omission of the State in the issue of prostitution, mainly embodied in absence of public policies directed to sexual rights and reproductive and generation of employment and income. Regarding the regulation of prostitution, the majority of the interviewees is contrary, arguing that exacerbate the stigma in this practice

Mulher como sujeito da criminalidade: um estudo sobre a realidade de presidiárias do complexo Penal Dr. João Chaves Natal/ RN

This work presents itself as a result of the research: Women as the subject of crime: a study on the complex reality of the criminal inmates Dr. John Keys - Natal / RN, done with women incarcerated in the Women's Pavilion Complex Criminal Dr. John Keys. Aimed to investigate the key determinants that lead women to enter the institution to be subject of crime. To better understand the object of our study, we start to understand and analyze the social reality, economic and cultural these women, as well as seizure of their family relationships and emotional, within a gender perspective and consider the analysis of major crimes committed and their determinations. In our study, it appears from successive approximations and procedures theoretical and methodological quality and quantity, we were privileged to documentary research, observation and semi-structured, beyond the theoretical foundation on the subject - that the question of increase in recent years, women in the criminal occurs as a result of socioeconomic reality experienced by those. At the same time, the study has also believe that poverty and crime are not phenomena of cause and effect, however, it is undeniable that the large number of prisoners (as) are poor and live situation of denial of rights. The main focus of the research points to the socio-emotional relationships, both marital and family as the main determinant for inclusion of women in crime, breaking with the myth that the woman is "fragile sex." And, more, points out that the woman in the process of emancipation and achievement of public spaces to commit a crime seek equal to the male. Moreover, the research also denounced in a prison system collapsed, and totally abandoned by the public. That denies all rights provided to prisoners (as), both inside and outside the "walls". It is a system that criminalizes and no one wants to fulfill its role, which is the functional rehabilitation and resocialization of (the) inmates (those). It is hoped that this work could contribute to the unveiling of the reality of women in the criminal - no pretension of exhausting it - and can also contribute to further studies on the subject