Associations, active citizenship, and the quality of democracy in Brazil and Mexico

In many Third Wave democracies large classes of people experience diminished forms of citizenship. The systematic exclusion from mandated public goods and services significantly injures the citizenship and life chances of entire social groups. In democratic theory civil associations have a fundamental role to play in reversing this reality. One strand of theory, known as civic engagement, suggests that associations empower their members to engage in public politics, hold state officials to account, claim public services, and thereby improve the quality of democracy. Empirical demonstration of the argument is surprisingly rare, however, and limited to affluent democracies. In this article, we use original survey data for two large cities in Third Wave democracies-So Paulo and Mexico City-to explore this argument in a novel way. We focus on the extent to which participation in associations (or associationalism) increases "active citizenship"aEuro"the effort to negotiate directly with state agents access to goods and services legally mandated for public provision, such as healthcare, sanitation, and security-rather than civic engagement, which encompasses any voluntary and public spirited activity. We examine separately associationalism's impact on the quality of citizenship, a dimension that varies independently from the level of active citizenship, by assessing differences in the types of citizenship practices individuals use to obtain access to vital goods and services. To interpret the findings, and identify possible causal pathways, the paper moves back-and-forth between two major research traditions that are rarely brought into dialogue: civic engagement and comparative historical studies of democratization

Periodontal disease is associated with poor self-rated oral health among Brazilian adults

Objective: The aim of this study was to investigate the association between periodontal disease and self-rated oral health among Brazilian adults. Material and Methods: Data on 11,874 adults in 250 cities from all the Brazilian regions were analysed. The outcome investigated was self-rated oral health (dichotomized into ‘‘Good’’ and ‘‘Poor’’) and the main exposure was periodontal disease defined as the combination of periodontal pocket depth X4mm and clinical attachment loss X4 mm. Demographic characteristics, socioeconomic conditions, clinical oral health conditions (dental caries, dental and gingival pain, tooth loss and use of prosthesis) and use of dental services were the other explanatory variables. Simple and multivariate Poisson regression was performed allowing the estimation of prevalence ratios (PRs). All analyses were adjusted for the cluster sampling design. Results: The prevalence of periodontal disease was 8.9% (95%CI 7.6–10.3) and poor self-rated oral health was 23.6% (95%CI 21.9–25.2) which was significantly higher among those who presented periodontal disease (PR 1.4; 95%CI 1.2–1.5), after the adjustment for possible confounders. Conclusions: Periodontal disease was associated with poor self-rated oral health. The results of this study should be considered by population health planners in order to assess and plan periodontal services.Andreia Morales Cascaes, Karen Glazer Peres and Marco Aurelio Pere