Influence of municipal socioeconomic indices on mortality rates for oral and oropharyngeal cancer in older adults in the State of São Paulo, Brazil

O câncer de boca e o câncer de orofaringe são doenças influenciadas por fatores socioeconômicos. O risco de desenvolver essas doenças aumenta com a idade, e a maioria dos casos ocorre em idosos, com elevadas taxas de mortalidade. O objetivo deste estudo foi analisar a influência dos índices socioeconômicos municipais nas taxas de mortalidade por câncer de boca (CB) e de orofaringe (CO) em idosos nas 645 cidades do estado de São Paulo, Brasil, nos anos de 2013 a 2015. Dados secundários de óbitos foram obtidos pelo Sistema de Informações sobre Mortalidade (SIM) do Ministério da Saúde. O número de idosos e os valores da renda média per capita e do índice de desenvolvimento humano por município (IDH-M) foram obtidos a partir dos dados da Fundação SEADE. Realizou-se a análise descritiva e exploratória dos dados, seguida de modelos binomiais negativos descritos pelo procedimento PROC GENMOD e avaliados pelo critério de informação de Akaike corrigido (AICc), pelo grau de liberdade e pelo teste de Wald (α=0,05). Cerca de 30% das cidades notificaram óbitos em 2013, 16,74% em 2014 e 18,61% em 2015. Astaxas médias de mortalidade por CB e CO foram, respectivamente, de 20,0 (± 30,9) e 10,7 (± 17,5) por 100 mil habitantes. A renda média variou de R$434,20 a R$ 2.009,00 e o IDH-M, de 0,65 a 0,89. Houve decréscimo significativo (p < 0,05) nas taxas de mortalidade por CB e CO em idosos com o aumento dos valores das rendas médias e do IDH-M. As desigualdades socioeconômicas das cidades influenciam nas taxas de mortalidade por CB e CO em idosos22Oral and oropharyngeal cancer are diseases strongly influenced by socioeconomic factors. The risk of developing these diseases increases with age and most cases occur in the elderly, with higher mortality rates. This study aimed to analyze the influence of municipal socioeconomic indices on mortality rates for oral (OC) and oropharyngeal cancer (OPC) in elderly residents from 645 cities in the State of São Paulo, Brazil, from 2013 to 2015. Secondary data on deaths were obtained in the Mortality Information System from the Brazilian Ministry of Health. The number of elderly, as well as per capita median income values and Human Development Index by municipality (HDI-M) values were obtained from data by the SEADE Foundation. Descriptive and exploratory analysis of data was performed, followed by negative binomial models described by the Proc Genmod procedure and evaluated by the corrected AIC (Akaike Information Criterion), the likelihood level, and the Wald test (α = 0.05). Around 30% of the cities notified deaths in 2013, 16.74% in 2014, and 18.61% in 2015. Founded mortality mean rates from OC and OPC were, respectively, 20.0 (± 430.9) and 10.7 (± 17.5) deaths per 100,000 inhabitants. Mean income ranged, in local currency, from 434.2 to 2,009.00. HDI-M ranged from 0.65 to 0.89. There was a significant decrease (p < 0.05) in mortality rates for OC and OPC in elderly with the increase in the cities’ mean income and HDI-M values. Socioeconomic inequalities in the cities the on mortality rates for OC and OPC in elderly resident

Social capital and factors associated with the caries experience in adults : a population-based study in Brazil

The objective of this study was to investigate the experience of caries related to social capital and associated factors in adults in large-scale population-based study. A Cross-sectional study was performed in 163 municipalities in the State of São Paulo, Brazil (SBSP-2015). 17,560 people were evaluated, of which 6051 were adults aged 35-44 years. Hierarchical logistic regression analysis was proposed. Outcome variables (decayed teeth, missing teeth and DMFT) and independent variables were included in the model, considering the distal (income and schooling); intermediate (social capital) and proximal levels (sex and ethnicity). Results showed that income up to 1,500 reais - US$ 367.6 in 11/11/2019 - (OR = 1.91;1.75-2.08), schooling up to 8 years (OR = 1.32;1.12-1.56) and non-white ethnicity (OR = 1.54;1.35-1.76) were more likely to have decayed teeth. Income up to 1500 reais (OR = 1.29;1.15-1.44), schooling up to 8 years (OR = 2.13;1.90-2.38), low social capital (OR = 1.84;1.65-2.04), medium social capital (OR = 1.15;1.01-1.30) and females were more likely to have lost teeth (OR = 1.13;1.03-1.23). Schooling up to 8 years (OR = 1.51;1.35-1.69), low social capital (OR = 1.25; 1.14-1.37) and female (OR = 1.40,1.19-1.53) were associated with DMFT. It was concluded that sociodemographic factors and low social capital were associated with the experience of caries, which should be taken into account in the formulation of public policies3

Malocclusion and dental appearance in underprivileged brazilian adolescents

Satisfaction with dental aesthetics is a subjective indicator used in epidemiological studies and is related to health behaviours. Little is known about the factors that influence this indicator, particularly among adolescents who live in a situation of social vulnerability. The aim of this study was to investigate the relationship between malocclusion and dental appearance in underprivileged Brazilian adolescents. This analytical cross-sectional study was conducted in Piracicaba, Brazil, and evaluated 884 adolescents from 13 to 19 years of age. The dependent variable was satisfaction with dental appearance, and the independent variables were classified as individual (components of the Dental Aesthetic Index - DAI, sex and age) and contextual (social exclusion index). For statistical analysis, multilevel regression models were estimated. The individual variables were considered Level 1, and the contextual variable was considered Level 2, with a level of significance of 5%. The mean age of the adolescents was 15.3 years. Female adolescents more frequently affirmed that they were satisfied with their dental appearance than did male individuals. There was an increase in dissatisfaction with oral health with the increase in anterior maxillary overjet, midline diastema, larger anterior irregularity in the maxilla, larger anterior irregularity in the mandible, anterior open bite and antero-posterior molar relation. Satisfaction with dental appearance was associated with individual factors such as sex and DAI components33CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQ141654/2013-

Variables Associated With The Performance Of Centers For Dental Specialties In Brazil [variáveis Associadas Ao Desempenho De Centros De Especialidades Odontológicas No Brasil]

The aim of this study was to evaluate the performance of the Centers for Dental Specialties (CDS) in the country and associations with sociodemographic indicators of the municipalities, structural variables of services and primary health care organization in the years 2004–2009. The study used secondary data from procedures performed in the CDS to the specialties of periodontics, endodontics, surgery and primary care. Bivariate analysis by χ2 test was used to test the association between the dependent variable (performance of the CDS) with the independents. Then, Poisson regression analysis was performed. With regard to the overall achievement of targets, it was observed that the majority of CDS (69.25%) performance was considered poor/ regular. The independent factors associated with poor/regular performance of CDS were: municipalities belonging to the Northeast, South and Southeast regions, with lower Human Development Index (HDI), lower population density, and reduced time to deployment. HDI and population density are important for the performance of the CDS in Brazil. Similarly, the peculiarities related to less populated areas as well as regional location and time of service implementation CDS should be taken into account in the planning of these services.174978988(2004) Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Coordenação Nacional de Saúde Bucal. Diretrizes da Política, , Nacional de Saúde Bucal. Brasília: Ministério da Saúde Brasil Ministério da SaúdeAntunes, J.L.F., Narvai, P.C., Políticas de saúde bucal no Brasil e seu impacto sobre as desigualdades em saúde (2010) Rev Saúde Pública, 44 (2), pp. 360-365Estabelece critérios, normas e requisitos para a implantação e credenciamento de Centros de Especialidades Odontológicas e Laboratórios Regionais de Próteses Dentárias, , http://dtr2001.saude.gov.br/sas/PORTARIAS/Port2004/GM/1570re.htm, Portaria no 1.570 de 2004. Disponível em (Acessado em 08 de março de 2012) Brasil. Ministério da SaúdeCoordenação Nacional de Saúde Bucal, , http://189.28.128.100/dab/docs/publicacoes/geral/serie_tecnica_11_port.pdf, A Política Nacional de Saúde Bucal do Brasil: registro de uma conquista histórica. (Série Técnica: Desenvolvimento de Sistemas e Serviços de Saúde). Disponível em: (Acessado em 15 de fevereiro de 2011), Brasil. Ministério da Saúde(2004) Secretaria de Atenção à Saúde, , Brasil. Ministério da Saúde. Departamento de Atenção Básica. Projeto SB BRASIL: condições de saúde bucal da população brasileira 2002- 2003: resultados principais. Brasília: Ministério da SaúdeNeri, M., Soares, W., Desigualdade social e saúde no Brasil (2002) Cad Saúde Pública, 18, pp. 77-87Portaria no 600 de 2006, , http://dtr2001.saude.gov.br/sas/PORTARIAS/Port2006/GM/GM-600.htm, Institui o financiamento dos Centros de Especialidades Odontológicas. Brasília: Ministério da Saúde2006. Disponível em: (Acessado em 15 de agosto 2013) Brasil. Ministério da SaúdePortaria no 599 de 2006, , http://www.brasilsus.com.br/index.php?option=com_content&view=article&id=885, Brasil. Ministério da Saúde. Disponível em: (Acessado em 15 de agosto de 2013]Sistemas e Aplicativos, , http://www2.datasus.gov.br/DATASUS/index.php?area=040805, Brasil. Ministério da Saude DATASUS - Departamento de Informática do SUS, 2011. Disponível em: (Acessado em 08 de setembro de 2011)Figueiredo, N., Goes, P.S.A., Construção da atenção secundária em saúde bucal: Um estudo sobre os Centros de Especialidades Odontológicas em Pernambuco, Brasil (2009) Cad Saúde Pública, 25 (2), pp. 259-267Relatório da tabela de domínio NFCES051 - HABILITAÇÕES, , Brasil. Ministério da Saúde DATASUS - Departamento de Informática do SUS, 2011. (Acessado em 29 de junho de 2011)Evolução do credenciamento e implantação das estratégias de Agentes Comunitários de Saúde, Saúde da Família e Saúde Bucal, , http://dab.saude.gov.br/historico_cobertura_sf.php, Brasil. Ministério da Saúde DAB. Unidade Geográfica: Município - Todos / Estados - Todos / Região - Todas. Competência: Dezembro de 2009. Disponível em (Acessado em 12 de novembro de 2011)Censo Demográfico 2010, , www.ibge.gov.br/home/presidencia/noticias/censo10052011.shtm, Brasil. Instituto Brasileiro de Geografia e Estatística. IBGE. Resultados Preliminares do Universo do Censo Demográfico 2010. DisponívelPrograma das Nações Unidas para o Desenvolvimento, Ranking decrescente do IDHM dos municípios, 2000, , http://www.pnud.org.br/atlas/ranking/IDH-M%2091%2000%20Ranking%20decrescente%20(pelos%20dados%20de%202000).xls, PNUD. Disponível em. (Acessado em 29 de agosto de 2011)Goes, P.S.A., Figueiredo, N., Neves, J.C., Silveira, F.M.M., Costa, J.F.R., Pucca Junior, G.A., Avaliação da atenção secundária em saúde bucal: Uma investigação nos centros de especialidades do Brasil (2012) Cad. Saúde Pública, 28, pp. S81-S8